Spleen and gastrosplenic ligament preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy

  • Masahiko Hirota
  • Atsushi Ichihara
  • Satoshi Furuhashi
  • Hiroshi Tanaka
  • Hiroshi Takamori
  • Hideo Baba
Surgeon at work

DOI: 10.1007/s00534-009-0113-7

Cite this article as:
Hirota, M., Ichihara, A., Furuhashi, S. et al. J Hepatobiliary Pancreat Surg (2009) 16: 792. doi:10.1007/s00534-009-0113-7

Abstract

Background

As a modification of hand-assisted laparoscopic pancreatectomy, we devised a method of spleen and gastrosplenic ligament preserving distal pancreatectomy, in which pancreatic resection is performed under direct vision extracorporeally.

Methods

The distal pancreas and spleen are pulled out of the peritoneal cavity through the minilaparotomy at the epigastrium following hand-assisted laparoscopic dissection of the distal pancreas. Spleen-preserving pancreatectomy is performed safely under direct vision. The gastrosplenic ligament is also preserved to prevent splenic volvulus after the operation. The transected main pancreatic duct is doubly ligated, and the transected pancreatic stump is sewn manually. The preserved spleen and splenic vessels are placed back in the peritoneal cavity after resection.

Results

In the current study (n = 3), overall morbidity rate, including splenic volvulus and pancreatic fistula, was 0%.

Conclusion

Preservation of the gastrosplenic ligament and extracorporeal preparation of the transected pancreatic stump under direct vision are useful measures in spleen-preserving distal pancreatectomy under a minimum incision approach assisted by laparoscopy.

Keywords

Laparoscopic pancreatectomy Hand-assisted laparoscopic pancreatectomy Spleen-preserving distal pancreatectomy Pancreatic fistula Minimum incision approach 

Copyright information

© Springer 2009

Authors and Affiliations

  • Masahiko Hirota
    • 1
  • Atsushi Ichihara
    • 2
  • Satoshi Furuhashi
    • 2
  • Hiroshi Tanaka
    • 2
  • Hiroshi Takamori
    • 2
  • Hideo Baba
    • 2
  1. 1.Department of SurgeryKumamoto Regional Medical CenterKumamotoJapan
  2. 2.Department of Gastroenterological SurgeryKumamoto University Graduate School of Medical SciencesKumamotoJapan

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