단일 기관에서 경험한 복강경 췌장 수술

Abstract

Purpose: This study aimed to access the characteristics of laparoscopic pancreas surgery and to compare the results between laparoscopy and conventional open surgery. Furthermore, we plan to offer guidance for performing laparoscopic pancreas surgery in the future. Methods: From March 2004 to September 2007, 27 patients underwent laparoscopic pancreas surgery (LP), including 2 Da Vinci robotic surgeries, at the Department of Surgery, Yonsei University College of Medicine. We reviewed the clinicopathologic characteristics of these cases and we compared the results to open surgery (OP) for treating low-grade solid pseudopapillary neoplasm (SPN) as a control group. Results: The locations of tumor were 3 at the head, 11 at the body and 13 at the tail. The postoperative pathologic diagnoses revealed 26 cases as benign disease and 1 as malignant disease. Sixteen of these cases underwent distal pancreatectomy, including 6 spleen-preserving procedures, of which 3 cases also had preservation of the splenic vessels, and the others had enucleation performed. There was no perioperative transfusion and 10 minor complications were seen, without any mortality. The mean amount of blood loss, the day of starting the diet and the length of the hospital stay were significantly less for the cases of laparoscopic surgery. There was no difference in the postoperative complications (p=0.537). Conclusion: In fact, laparoscopic pancreas surgery is feasible and safe even if it does present some challenges. So if possible, it could also be applied to various kinds of pancreatic surgeries, including those for malignancy. However, the surgeons need accumulated skill and experience, and careful selection of the patients for laparoscopic pancreas surgery is required to achieve better results.