Application value of three-dimensional laparoscope in spleen-preserving distal pancreatectomy

Objective To investigate the application value of three-dimensional (3D) laparoscope in spleen-preserving distal pancreatectomy, and summarize the clinical experience and surgical skills. Methods Clinical data of 16 patients with space-occupying lesions at the body and tail of pancreas who underwent 3D laparoscopic spleen-preserving distal pancreatectomy in Hunan Provincial People's Hospital from January 2014 to May 2016 were retrospectively analyzed. There were 5 males and 11 females with the age ranging from 23 to 64 years old and the median of 43 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. All patients underwent spleen-preserving distal pancreatectomy using Kimura's procedure. During the operation, the splenic artery and vein were isolated and preserved behind the pancreas, and the body and tail of pancreas were resected. Intraoperative and postoperative conditions were observed and all patients were followed up. Results All patients underwent 3D laparoscopic spleen-preserving distal pancreatectomy successfully. The median operation time was 216 (150-285) min. The intraoperative blood loss was 273 (150-500) ml. No conversion to open surgery was observed during the surgery. Two cases of pancreatic fistula were observed after surgery, 1 case was cured by conservative therapy, and the other case was complicated with bleeding and was cured by reoperation. No death was observed after surgery. The postoperative length of hospital stay was 11 (5-29) d. Postoperative pathological examination indicated that 5 cases presented with serous cystadenoma, 4 with mucinous cystadenoma, 3 with retention cysts, 2 with solid pseudopapuillary tumors and 2 with functional islet cell tumors. The postoperative follow-up time was 9 (1-28) months, the patients had a good living quality and no recurrence was observed. Conclusions The 3D laparoscopic spleen-preserving distal pancreatectomy is an efficacious, safe and feasible procedure for distal pancreatic benign or borderline tumors. It has the advantages of minimal invasion, low incidence of postoperative complications and fast postoperative recovery. Key words: Imaging, three-dimensional; Laparoscopes; Pancreatectomy; Pancreatic neoplasms