[Pancreatic neuroendocrine tumour - laparoscopic distal pancreatectomy with splenectomy and partial gastric resection].

PURPOSE

In selected patients laparoscopic distal pancreatectomy with splenectomy has increasingly gained in importance as an alternative to the open approach. Modern imaging procedures detect more frequently neuroendocrine pancreatic tumours. A typical feature of the neuroendocrine pancreatic tumour is that this kind of tumour is mostly small with a size of 1 to 2 cm. Due to their mostly small size they are suited to a laparoscopic approach. We report here the feasibility and surgical technique of a laparoscopic distal pancreatectomy with splenectomy and partial gastric resection due to a neuroendocrine pancreatic tumour.

INDICATION

We describe a 74-year-old asymptomatic man (BMI: 28 kg/m2) with a 1.5 cm neuroendocrine tumour in the tail of the pancreas.

METHOD

Laparoscopic distal pancreatectomy with splenectomy was performed using the 4-trocar technique in the 45-degree right lateral position. Due to a suspected tumour located at the greater curvature additionally a partial gastric resection was performed. Operative time was 184 min and intraoperative blood loss was 50 ml. The postoperative values of lipase and amylase in drainage were normal. No intraoperative or postoperative complications were recorded. The patient convalesced without complication and went home 7 days after surgery.

CONCLUSION

Laparoscopic distal pancreatectomy with or without splenectomy is feasible with a low morbidity rate by experienced laparoscopic surgeons. The advantages of laparoscopic compared to open approach are well known, but the laparoscopic approach in pancreatic surgery should be used in selected patients. Due to their mostly small size, especially neuroendocrine tumours in the tail of the pancreas are suited to a laparoscopic approach.