Pancreatectomiile distale laparoscopice in leziuni benign

Abstract

Pancreatectomia distala este o procedura standard pentru tumorile benigne sau maligne cu risc scazut. Abordul laparoscopic cu prezervarea splinei ramane in continuare o procedura de dificultate tehnica mai ridicata. Desi avansurile tehnologice si laparoscopice recente au facilitat realizarea acestei procedure, exista o serie de pasi cheie care trebuie mentinuti. Studiile recente au demonstrat beneficiile pe termen scurt si lung in prezervarea splinei, precum reducerea riscului de sepsa, astfel ca de fiecare data cand este posibil, prezervarea splinei este standardul de aur. Aceasta prezentare subliniaza indicatiile abordului laparoscopic, prezentand pasii respectati in ingrijirea preoperatorie, tehnica operatorie explicate in detaliu cu enuntarea pasilor important, metodele de prezervare a splinei precum si ingrijirea si urmarirea postoperatorie.

Distal pancreatectomy is a standard procedure for benign tumors or tumors with low risk of malignancy. Laparoscopic distal pancreatectomy with preservation of the spleen is a technically demanding procedure. Although recent technical and laparoscopic advances have made the procedure more feasible and accessible, there are important steps that need to be maintained. Previous studies have shown both the short and long-term benefits of spleen preservation, such as lowering the risk of sepsis, therefore whenever it’s possible, splenic preservation should be the standard of care. This presentation highlights the indications for the laparoscopic approach, presenting the important steps in the preoperative care of such patient, the surgical technique described in detail with enunciation of the key steps, the methods of spleen preservation as well as the postoperative care and follow-up.