Laparoscopically assisted total pancreatectomy : feasible minimally invasive alternative to open resection]

Minimally invasive techniques are being used increasingly more in pancreatic surgery. Compared to resections of the pancreatic head and tail, total pancreatectomy is rarely performed. As no pancreatic anastomosis has to be made and open resection usually needs a wide laparotomy, a laparoscopically assisted technique seems desirable. The objective of this article is to report the initial results of laparoscopically assisted total pancreatectomy in three patients. This series included two patients with a main duct type intraductal papillary mucinous neoplasm (IPMN) and one patient with pancreatic metastases from a renal carcinoma. All three resections were achieved laparoscopically. Reconstruction was performed through the retrieval incision. Operative time, blood loss, intermediate care and hospital stay were similar to a control group of open resections in seven patients. In this small group of selected patients laparoscopic total pancreatectomy is feasible when carried out in centers with high expertise in laparoscopy and pancreatic surgery.