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KMID : 1035920160190030089
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Journal of Minimally Invasive Surgery
2016 Volume.19 No. 3 p.89 ~ p.96
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Safety and Feasibility of Single Incision Laparoscopic Spleen Preserving Distal Pancreatectomy
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Lee Hui-Song
Heo Jin-Seok
Choi Seong-Ho
Choi Dong-Wook
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Abstract
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Purpose: Single-incision laparoscopic distal pancreatectomy (SIL-DP) has recently been attempted in the treatment of left-sided benign neoplasms of the pancreas. This study was conducted to evaluate the perioperative outcomes of SIL-DP compared with conventional laparoscopic DP (CL-DP).
Methods: Patients who received laparoscopic DP from a single surgeon for benign pancreatic neoplasm from January 2012 to January 2014 were included. The patients were divided into two groups, SIL-DP and CL-DP. We used four trocars for CL-DP and a custom-made glove port for SIL-DP and analyzed the conversion cases separately. Perioperative outcomes were compared between types of surgery.
Results: SIL-DP was attempted in 13 patients, five of whom required conversion to CL-DP or dual-incision surgery. CL-DP was attempted in 27 patients and all were successful without open conversion. The spleen was preserved in all patients who underwent SIL-DP without conversion, in four of five (80%) in the conversion group, and 21 (78%) of those who underwent CL-DP. The complication rate was 13% in the SIL-DP-only group, 60% in the conversion group, and 19% in the CL-DP group. The operation time, estimated blood loss, numeric pain intensity score, and hospital duration were similar in the SIL-DP and CL-DP groups.
Conclusion: SIL-DP was associated with a moderate need for an additional port, and the complication rate was high in the conversion group. Our findings indicate that SIL-DP should be attempted carefully. Further studies are needed to evaluate the long term follow-up outcomes of SIL-DP.
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KEYWORD
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Laparoscopy, Pancreatectomy, Minimally invasive surgical procedures
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