Minimal-invasive Resektion neuroendokriner Pankreastumoren

Langer, Peter; Fendrich, Volker; Bartsch, Detlef K.

doi:10.1007/s00104-008-1613-8

Cited by 9 publications

(4 citation statements)

References 29 publications

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“…In contrast, others have demonstrated the feasibility of laparoscopic, oncologic adequate pancreatic surgery, especially with respect to the criterion of a tumour‐free resection margin . However, evidence‐based data on oncologic, minimally‐invasive pancreatic surgery are still missing . The lack of preoperative differentiation and the radicality of lymph node dissection are the main problems .…”

Section: Discussionmentioning

confidence: 99%

“…27,28 However, evidence-based data on oncologic, minimally-invasive pancreatic surgery are still missing. 29 The lack of preoperative differentiation and the radicality of lymph node dissection are the main problems. 30 A potential bias of the current study also concerning the operation time is a positive selection of patients with benign disease.…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Schloericke¹,

Zimmermann²,

Roblick³

et al. 2012

Surgical Practice

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Aim The increasing experience within the area of laparoscopic procedures has paved the way for technically‐complex procedures, such as distal pancreatectomy. In order to avoid complications associated with concomitant splenectomy, these procedures are increasingly performed with spleen preservation. A drawback is the low number of cases, which does not allow for an evidence‐based comparison between laparoscopic and open procedures, and spleen‐preserving and concomitant splenectomy procedures. Patients and Methods Between 2006 and 2010, all data for patients who underwent a laparoscopic distal pancreatectomy (LDP) at the Department of Surgery, University of Schleswig‐Holstein, Luebeck, Germany, were collected are stored in a prospectively‐maintained database. Patients with tumours in the pancreatic tail and body that did not exceed the level of the portal vein were included in this database. Results A total of 22 patients who underwent LDP could be included in the evaluation. Ten of those patients underwent a laparoscopic spleen‐preserving distal pancreatectomy (LSPDP), while the remaining 12 received an LDP with splenectomy (LDPwS). The median operation time was 155 min (range: 98–253) for the LSPDP group, and 201 min (range: 60–310) for the LDPwS group (P = 0.06). The median hospital stay was 8.5 days (range: 5–23) in the LSPDP group compared to 11 days (range: 4–41) in the LDPwS group (P = 0.06). Pancreatic fistula occurred in two patients from each group. It caused an intraabdominal haemorrhage in one patient of the LSPDP group, which required re‐laparoscopy. Two patients experienced subphrenic abscesses in the LDPwS group and were treated interventionally. Histological examination revealed six cystadenomas and five pseudocysts (maximum diameter: 7 cm) in the LDPwS group, and six neuroendocrine tumours (maximum diameter: 2 cm) in the LSPDP group. Conclusion LDP can be performed safely. The optic magnification provided by laparoscopy facilitates LSPDP, as dissection of the splenic vessels can be avoided. Although not significant, there was a trend towards reduced hospital stay and operating time for LSPDP. Oncologic outcomes and morbidity seem to not be inferior to open procedures. The size of the tumours and the peripancreatic, as well as paraneoplastic, tissue alterations determine the indication for splenectomy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Schloericke¹,

Zimmermann²,

Roblick³

et al. 2012

Surgical Practice

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“…C-LDP was performed with a 4-trocar technique as previously reported by our group [21] . Briefly, the gastrocolic ligament was dissected with a harmonic scalpel (Ultracision, Fa.…”

Section: Surgical Techniquementioning

confidence: 99%

Robotic-Assisted Approach Improves Vessel Preservation in Spleen-Preserving Distal Pancreatectomy

et al. 2016

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Background: Vessel-preserving spleen preservation (SP) during distal pancreatectomy (DP) is supposed to be beneficial for patients with benign and borderline tumors. This study evaluated the first experiences with robotic-assisted laparoscopic DP (RA-LDP) and its rate of vessel preservation and SP compared to conventional laparoscopic DP (C-LDP). Methods: Patients scheduled for spleen-preserving DP for benign or borderline tumors by either C-LDP or RA-LDP were retrieved from a prospective database and retrospectively analyzed regarding vessel-preservation and SP, conversion rate, blood loss, operating time, complications, perioperative blood transfusion, postoperative hospital stay (PHS) and mortality. Results: Twenty-nine patients underwent C-LDP and 12 patients underwent RA-LDP between September 2009 and May 2015. SP rates were 79% (23 of 29) in the C-LDP and 92% (11 of 12) in the RA-LDP group (p = 0.32). Splenic vessels could be preserved in 17% (5 of 29) of the C-LDP and 50% (6 of 12) of the RA-LDP group (p = 0.052). Operating time, intraoperative blood loss, the number of perioperative red blood cell transfusions, overall morbidity and the rate of postoperative pancreatic fistulas were not different between the groups. PHS was shorter in the RA-LDP group (10.5 vs. 13 days; p = 0.02). Conclusion: RA-LDP for benign or borderline tumors of the pancreas is a safe procedure and tended to be associated with a better vessel-preservation rate, thereby making it a good alternative to C-LDP.

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“…Laparoscopic resection of sporadic PNETs has been reported by several groups as case reports or series [11–17]. However, the current reported cases are, to the best of our knowledge, the first descriptions of organ‐sparing pancreatic surgery in VHL patients.…”

Section: Discussionmentioning

confidence: 98%

Laparoscopic Organ‐Sparing Resection of Von Hippel‐Lindau Disease‐Associated Pancreatic Neuroendocrine Tumors

Dücker¹,

Walz

Voss³

et al. 2010

World j. surg.

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Minimal-invasive Resektion neuroendokriner Pankreastumoren

Cited by 9 publications

References 29 publications

Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Laparoscopic spleen‐preserving distal pancreatectomy: A consecutive series at an experienced centre

Robotic-Assisted Approach Improves Vessel Preservation in Spleen-Preserving Distal Pancreatectomy

Laparoscopic Organ‐Sparing Resection of Von Hippel‐Lindau Disease‐Associated Pancreatic Neuroendocrine Tumors

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