ASO Author Reflections: From Concept to Real Clinical Practice of Laparoscopic Distal Pancreatectomy for Left-Sided Pancreatic Cancer

Excerpt

In spite of the potential clinical benefit of minimally invasive surgery, laparoscopic distal pancreatectomy (LDP) was contraindicated for left-sided pancreatic cancer. The pancreas is located in the retroperitoneal space, and there are important vascular structures near the pancreas, making the laparoscopic approach difficult. In addition, most left-sided pancreatic cancers are found in an advanced stage at diagnosis. Fears for incomplete radical surgery were widespread, which prevented intention-to-treat LDP for distal pancreatic cancer. However, with the advance of surgical techniques and experiences, efforts were carefully made to apply LDP for left-sided pancreatic cancer in selected patients. According to our institutional experience,1^,2 bloodless and margin-negative resection were identified as independent prognostic factors in resected left-sided pancreatic cancer. Ideal tumor conditions were proposed (Yonsei criteria) as potential indicators for bloodless and margin-negative LPD for left-sided pancreatic cancer. …