Laparoscopic distal pancreatectomy: Does size matter?

Background: The feasibility and safety of laparoscopic pancreatic surgery has now been well documented in many retrospective re-views. However, the pre operative patient selection parameters for laparoscopic pancreatic surgery are still evolving. Methods: A retrospective analysis of all 29 patients who underwent laparoscopic pancreatic interventions between January 2007 and October 2009 at our hospital was performed. Results: A total of 12 patients (5 women) were included in the study group. One was converted to open resection secondary to ex-tensive adhesions. The pancreatic fistula rate (n=1; 8.3%) and overall morbidity (33%) of this study are comparable with other stud-ies of open and laparoscopic distal pancreatectomy. In analyzing our patient subset with major complications, we found that all 7 major complications occurred in 4 patients, 3 of whom had large tumor size (>= 5cm, range 5-10cm). Conclusion: We conclude that while the morbidity does not seem to correlate with benign vs. malignant pathology, tumor size does seem to play an important role and should be a significant factor in patient selection for laparoscopic pancreatic resections.