Rationale: Laparoscopic total pancreatectomy is a complicated surgical procedure and rarely been reported. This study was conducted to investigate the safety and feasibility of laparoscopic total pancreatectomy.
Patients and Methods: Three patients underwent laparoscopic total pancreatectomy between May 2014 and August 2015. We reviewed their general demographic data, perioperative details, and short-term outcomes. General morbidity was assessed using Clavien-Dindo classification and delayed gastric emptying (DGE) was evaluated by International Study Group of Pancreatic Surgery (ISGPS) definition.
Diagnosis and Outcomes: The indications for laparoscopic total pancreatectomy were intraductal papillary mucinous neoplasm (IPMN) (n=2) and pancreatic neuroendocrine tumor (PNET) (n=1). All patients underwent laparoscopic pylorus and spleen-preserving total pancreatectomy, the mean operative time was 490 minutes (range 450-540 minutes), the mean estimated blood loss was 266mL (range 100-400 minutes); 2 patients suffered from postoperative complication. All the patients recovered uneventfully with conservative treatment and discharged with a mean hospital stay 18 days (range 8-24 days). The short-term (from 108 to 600 days) follow up demonstrated 3 patients had normal and consistent glycated hemoglobin (HbA1c) level with acceptable quality of life.
Lessons: Laparoscopic total pancreatectomy is feasible and safe in selected patients and pylorus and spleen preserving technique should be considered. Further prospective randomized studies are needed to obtain a comprehensive understanding the role of laparoscopic technique in total pancreatectomy.
Key words: PYLORUS-PRESERVING PANCREATICODUODENECTOMY; ROBOTIC TOTAL PANCREATECTOMY; SEVERE CHRONIC-PANCREATITIS; ISLET-CELL TRANSPLANTATION; GASTRIC-EMPTYING DGE; LONG-TERM OUTCOMES; INTRADUCTAL PAPILLARY; DISTAL PANCREATECTOMY; SPLENIC ARTERY; CANCER
引用本文： . . 华西虚拟期刊, 2000, 1(1): -. doi: 10.1097/MD.0000000000005869 复制