Surgical approaches for minimally invasive distal pancreatectomy: A systematic review
Issued Date
2022-01-01
Resource Type
ISSN
18686974
eISSN
18686982
DOI
Scopus ID
2-s2.0-85101655568
Pubmed ID
33527758
Journal Title
Journal of Hepato-Biliary-Pancreatic Sciences
Volume
29
Issue
1
Start Page
151
End Page
160
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of Hepato-Biliary-Pancreatic Sciences Vol.29 No.1 (2022) , 151-160
Suggested Citation
Ban D. Surgical approaches for minimally invasive distal pancreatectomy: A systematic review. Journal of Hepato-Biliary-Pancreatic Sciences Vol.29 No.1 (2022) , 151-160. 160. doi:10.1002/jhbp.902 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/86777
Title
Surgical approaches for minimally invasive distal pancreatectomy: A systematic review
Author(s)
Author's Affiliation
Siriraj Hospital
Graduate School of Medical Sciences
Graduate School of Medical and Dental Sciences
Graduate School of Medicine
Sapienza Università di Roma
Kagoshima University
Tokyo Women's Medical University
National Cancer Center Hospital
Yonsei University College of Medicine
Tokyo Medical University
Seoul National University College of Medicine
Graduate School of Medical Sciences
Graduate School of Medical and Dental Sciences
Graduate School of Medicine
Sapienza Università di Roma
Kagoshima University
Tokyo Women's Medical University
National Cancer Center Hospital
Yonsei University College of Medicine
Tokyo Medical University
Seoul National University College of Medicine
Other Contributor(s)
Abstract
Background: Minimally invasive distal pancreatectomy (MIDP) was initially performed for benign tumors, but recently its indications have steadily broadened to encompass other conditions including pancreatic malignancies. Thorough anatomical knowledge is mandatory for precise surgery in the era of minimally invasive surgery. However, expert consensus regarding anatomical landmarks to facilitate the safe performance of MIDP is still lacking. Methods: A systematic literature search was performed using keywords to identify articles regarding the vascular anatomy and surgical approaches/techniques for MIDP. Results: All of the systematic reviews revealed that MIDP was not associated with an increase in postoperative complications. Moreover, most showed that MIDP resulted in less blood loss than open surgery. Regarding surgical approaches for MIDP, a standardized stepwise procedure improved surgical outcomes, including blood loss, operative time, and major complications. There are two approaches to the splenic vessels, superior and inferior; however, no study has ever directly compared them with respect to clinical outcomes. The morphology of the splenic artery affects the difficulty of approaching the artery's root. To select an appropriate dissecting layer when performing posterior resection, thorough knowledge of the anatomy of the fascia, left renal vein/artery, and left adrenal gland is needed. Conclusions: In MIDP, a standardized approach and precise knowledge of anatomy facilitates safe surgery and has the advantage of a shorter learning curve. Anatomical features and landmarks are particularly important in cases of radical MIDP and splenic vessel preserving MIDP.