Laparoscopic Distal Pancreatectomy: How I Do It

  • Bergthor BjörnssonEmail author
  • Per Sandström


After the widespread introduction of laparoscopic surgery being more and more frequently applied to both benign and malignant lesions, this technique has now become the golden standard for benign and premalignant tumors in the body and the tail of the pancreas. The main reasons for this are decreased blood loss and reduced need for hospital stay, which has been fairly well documented although randomized controlled trials are missing. The use of laparoscopy for distal pancreatectomy in the cases of pancreatic adenocarcinomas is less studied and still not as widespread. There is however some evidence that even this situation can be treated with laparoscopic approach with similar results as open surgery.

This chapter describes an approach to laparoscopic spleno-pancreatectomy in the settings of suspected or confirmed pancreatic adenocarcinoma. The specific approach to locally advanced tumors demanding vascular resections or multi-organ resections is outside the scope of this text.


  1. 1.
    Cuschieri A, Jakimowicz JJ, van Spreeuwel J. Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. Ann Surg. 1996;223(3):280–5.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Ueno T, Oka M, Nishihara K, Yamamoto K, Nakamura M, Yahara N, et al. Laparoscopic distal pancreatectomy with preservation of the spleen. Surg Laparosc Endosc Percutan Tech. 1999;9(4):290–3.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Vezakis A, Davides D, Larvin M, McMahon MJ. Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors. Surg Endosc. 1999;13(1):26–9.CrossRefPubMedGoogle Scholar
  4. 4.
    Bjornsson B, Sandstrom P. Laparoscopic distal pancreatectomy for adenocarcinoma of the pancreas. World J Gastroenterol. 2014;20(37):13402–11.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Jin T, Altaf K, Xiong JJ, Huang W, Javed MA, Mai G, et al. A systematic review and meta-analysis of studies comparing laparoscopic and open distal pancreatectomy. HPB (Oxford). 2012;14(11):711–24.CrossRefGoogle Scholar
  6. 6.
    Clarke DL, Clarke BA, Thomson SR, Garden OJ, Lazarus NG. The role of preoperative biopsy in pancreatic cancer. HPB (Oxford). 2004;6(3):144–53.CrossRefGoogle Scholar
  7. 7.
    Rasmussen MS, Jorgensen LN, Wille-Jorgensen P, Nielsen JD, Horn A, Mohn AC, et al. Prolonged prophylaxis with dalteparin to prevent late thromboembolic complications in patients undergoing major abdominal surgery: a multicenter randomized open-label study. J Thromb Haemost. 2006;4(11):2384–90.CrossRefPubMedGoogle Scholar
  8. 8.
    Patterson EJ, Gagner M, Salky B, Inabnet WB, Brower S, Edye M, et al. Laparoscopic pancreatic resection: single-institution experience of 19 patients. J Am Coll Surg. 2001;193(3):281–7.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Singapore Pte Ltd. 2018

Authors and Affiliations

  1. 1.Department of Surgery and Department of Clinical and Experimental MedicineLinköping UniversityLinköpingSweden

Personalised recommendations