Laparoscopic pancreatic resection: Single-institution experience of 19 patients

BACKGROUND: The number of laparoscopic pancreatic resections reported in th e surgical literature has been remarkably low. Few substantive data are ava ilable concerning current indications and outcomes after laparoscopic pancr eatectomy. The purpose of this article is to review the recent indications, complications, and outcomes after laparoscopic pancreatic resection. STUDY DESIGN: A retrospective analysis of the Mount Sinai hospital records was performed for ail patients who underwent laparoscopic distal. pancreate ctomy or enucleation between the time of the First resection in November 19 93 until the time of this study in March 2000. RESULTS: In the 19 patients (6 men) the mean age was 53 years (range 22 to 83 years). In 16 patients (84%) the entire procedure was done by laparoscop y; one operation was converted to a hand-assisted technique; and two cases were converted to open. Median operating time was 4.4 hours grange 1.6 to 6 .6 hours), and median intraoperative blood loss was 200 mL. Postoperative c omplications included three pancreatic leaks (16%), one case of superficial phlebitis, and one prolonged ileus for 7 days (total morbidity of 26%). Th ere were no deaths. The median length of postoperative hospital stay was 6 days (range 1 to 26 days). CONCLUSIONS: This represents the largest single-institution experience with laparoscopic pancreatic resection. The considerable morbidity rate is comp arable to recently published open series, and is likely inherent in pancrea tic surgery, rather than the technical approach. Laparoscopic pancreatic su rgery resulted in shorter hospital stays and appears to be safe for benign diseases. (J Am Coll Surg 2001; 193-281-287. (C) 2001 by the American Colle ge of Surgeons).