>Year 2008, Issue 3
Lozano DG, Ortiz MRG, Figueroa BS, Maldonado PDG, Rentería OLM
Laparoscopic distal pancreatectomy with preservation of the spleen: a one-case report
Cir Gen 2008; 30 (3)
PDF: 4. Kb.
Objective: To present the resection of the body and tail of the pancreas with splenic preservation by means of laparoscopy in a female patient coursing with an epithelial retention cyst.
Setting: Third level health care hospital.
Design: Case presentation.
Case report: Woman, 41-year-old, without antecedents, with a 6-month history of postprandial colic-type pain in the epigastrium and left iliac fossa, of moderate intensity, which exacerbated in the last 15 days. Pain is accompanied by abdominal distension, flatulence, liquid stools without mucus or blood, normal vital signs, painful, soft abdomen, depressible, with pain at mid-palpation in the epigastrium and left iliac fossa, without data of peritoneal irritation or visceral-megaly, peristalsis was present. Antigen 19.9 laboratory studies revealed a 40.4 ng/ml value, Abdominal tomography revealed the presence of a redundant colon and simple, unilocular, serous pancreatic cyst of 34 mm in diameter, located in the body of the pancreas. Resection of the body and tail of the pancreas with spleen preservation was performed by means of laparoscopy, dissecting the splenic vein and artery, sectioning the pancreas with a lineal 6.0-3.5 stapler, and placing a drainage, no complications occurred. Surgery lasted 225 min, bleeding amounted to 100 ml. Histology reported a real solitary pancreatic cyst, compatible with epithelial retention. The patient had a satisfactory evolution.
Conclusion: Distal laparoscopic pancreatectomy is a safe and efficacious technique used for benign tumors, with early recovery and better cosmetic results. Preservation of the spleen and its vessels is the most important aspect of the procedure.
||Pancreatic resection, distal pancreatectomy, splenic preservation, laparoscopic resection.
Uranues S, Alimoglu O, Todoric B, Toprak N, Auer Th, Rondon L, et al. Laparoscopic resection of the pancreatic tail with splenic preservation. Am J Surg 2006; 192: 257-61.
Lee KK, Chen D, Hughes SJ. Minimally invasive treatment of pancreatic disease. Gastroenterol Clin North Am 2007; 36: 441-54.
Eom BW, Jang JY, Lee SE, Han HS, Yoon YS, Kim SW. Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc 2008; 22: 1334-1338.
Fernández-Cruz L, Pardo F, Cugat E, Artigas V, Olsina J, Rotellar F, et al. Análisis del registro nacional español de la cirugía laparoscópica del páncreas. Cir Esp 2006; 79: 293-298.
Rodríguez JR, Madanat MG, Healy BC, Thayer SP, Warshaw AL, Fernández-del Castillo C. Distal pancreatectomy with splenic preservation revisited. Surgery 2007; 141: 619-625.
Carrère N, Abid S, Julio CH, Bloom E, Pradère B. Spleen-preserving distal pancreatectomy with excision of splenic artery and vein: a case-matched comparison with conventional distal pancreatectomy with splenectomy. World J Surg 2007; 31: 375-382.
>Year 2008, Issue 3