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Two Anatomical Pathways for Retroperitoneoscopic Pancreatectomy: Indications for the Posterior and Lateral Approaches

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An Erratum to this article was published on 31 October 2014

Abstract

Background

Retroperitoneoscopic pancreatectomy (RP) is a novel surgical procedure that is safe and feasible in animal models and clinical practice. However, the optimal approach for RP has not been established.

Objective

This study aimed to introduce the posterior and lateral approaches for RP.

Methods

This prospective study included 19 patients with suspected pancreatic lesions who underwent RP. RP was performed using either a posterior or a lateral approach.

Results

The posterior, lateral, and jointed approaches were used in 13 (68.4 %), 3 (15.8 %), and 3 (15.8 %) cases, respectively. Patients underwent enucleation (N = 8), distal pancreatectomy (N = 4), and resection of cystic pancreatic lesions (N = 2) and non-pancreatic lesions (N = 5). All retroperitoneoscopic procedures were successfully accomplished with no conversion to open or laparoscopic surgery. Intraoperative complications occurred in two (12.5 %) cases, including one case with injury to the peritoneum and one case with injury to the peritoneum and splenic vein. Postoperative grade A pancreatic fistulas occurred in six cases, and were cured by delayed drainage. No disease recurrence or abnormal symptoms were observed during the mean follow-up period of 14.06 ± 9.60 months.

Conclusions

RP using the posterior or lateral approach is feasible and effective, but has different indications. The posterior approach is useful for distal pancreatectomy, as well as resection of pancreatic lesions in the posterior or superoposterior region of the distal pancreas. The lateral approach is useful for resection of pancreatic lesions in the anterior or inferior region of the body and tail. The two approaches can be used in combination or conversion.

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Conflict of interest

Drs. Guodong Zhao, Minggen Hu, Zhiming Zhao, Yong Xu, Huinian Zhou, Xuefei Wang, Xinning Zhang and Prof. Rong Liu have no conflicts of interest or financial ties to disclose

Author information

Authors and Affiliations

  1. Department of Surgical Oncology/Hainan Branch, Chinese People’s Liberation Army (PLA) General Hospital, 28 Fu Xing Road, Beijing, 100853, China

    Guodong Zhao, Minggen Hu, Rong Liu, Zhao Zhiming, Xuefei Wang & Xinning Zhang

  2. Department of Hepatobiliary Surgery, The 1st Affiliated Hospital of Chinese People’s Liberation Army (PLA) General Hospital, Beijing, 100037, China

    Yong Xu

  3. Department of General Surgery, Lanzhou University Second Hospital, Lanzou, 730030, China

    Huinian Zhou

Authors
  1. Guodong Zhao
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  2. Minggen Hu
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  3. Rong Liu
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  4. Zhao Zhiming
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  5. Yong Xu
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  6. Huinian Zhou
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  7. Xuefei Wang
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  8. Xinning Zhang
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Corresponding author

Correspondence to Guodong Zhao.

Additional information

Guodong Zhao and Minggen Hu contributed equally to this study.

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Zhao, G., Hu, M., Liu, R. et al. Two Anatomical Pathways for Retroperitoneoscopic Pancreatectomy: Indications for the Posterior and Lateral Approaches. World J Surg 38, 3023–3032 (2014). https://doi.org/10.1007/s00268-014-2654-4

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  • DOI: https://doi.org/10.1007/s00268-014-2654-4

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