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Background: Laparoscopic distal pancreatectomy (LDP) has been shown to be an effective surgical option for benign lesions in the body and tail of the pancreas. However, its advantages and disadvantages have not been well characterized. In this study, we compared the outcomes of LDP and open pancreatectomy performed in our clinic. Materials and Methods: Peri- and postoperative outcomes were retrospectively compared between patients with benign pancreatic disorders who underwent open distal pancreatectomy (ODP) (n=35) and those who underwent LDP (n=40). The peri- and postoperative factors analyzed included operative time, blood loss, hospital stay, postoperative recovery, biochemical findings and complications. Results: LDP was associated with significantly less operative blood loss (363 vs 606 ml; P = 0.001), shorter hospital stay (22 vs 27 day; P = 0.009), but longer operative time (342 vs 250 min; P = 0.000), compared with ODP. There were no significant differences between the two groups in complication rates or postoperative recovery except for significantly shorter duration of postoperative pain killer intake and earlier improvement of the biochemical analysis in LDP than in ODP. Conclusions: LDP appears to be a safe and desirable procedure for the management of benign pancreatic diseases, with outcomes similar to ODP.

Background: Laparoscopic distal pancreatectomy (LDP) has been shown to be an effective surgical option for benign lesions in the body and tail of the pancreas. However, its advantages and disadvantages have not been well characterized. In this study, we compared the outcomes of LDP and open pancreatectomy performed in our clinic. Materials and Methods: Peri- and postoperative outcomes were retrospectively compared between patients with benign pancreatic disorders who underwent open distal pancreatectomy (ODP) (n=35) and those who underwent LDP (n=40). The peri- and postoperative factors analyzed included operative time, blood loss, hospital stay, postoperative recovery, biochemical findings and complications. Results: LDP was associated with significantly less operative blood loss (363 vs 606 ml; P = 0.001), shorter hospital stay (22 vs 27 day; P = 0.009), but longer operative time (342 vs 250 min; P = 0.000), compared with ODP. There were no significant differences between the two groups in complication rates or postoperative recovery except for significantly shorter duration of postoperative pain killer intake and earlier improvement of the biochemical analysis in LDP than in ODP. Conclusions: LDP appears to be a safe and desirable procedure for the management of benign pancreatic diseases, with outcomes similar to ODP.

Purpose: A prospective study to evaluate the postcholecystectomy problem management. Patients and Methods: From March 2005 to April 2007, 210 patients were managed using surgery, endoscopy, and percutaneous approaches. Results: Endoscopy was therapeutic in 183 cases [stones (81), stricture (55), leakage (35)], and only diagnostic in 24 cases. Percutaneous approaches were carried out in 34 cases as diagnostic in 19 cases, stenting in 2 cases, and combined with endoscopy in 13 cases. Surgery was carried out in 40 cases either urgent in 10 cases (4.8%), or planned in 30 cases (14.3%), for peritoneal lavage in 7 cases, choledocholithotomy in 8 cases, undo ligation and T-tube drainage in 5 cases, common bile duct repair splinted by T tube in 3 cases, choledochoduodenostomy in 1 case, and Roux-en-Y choledochojejunostomy in 18 cases. Conclusions: Endoscopy is effective and safe not only for diagnostic but also for therapeutic approaches, especially when combined with percutaneous approaches that help in failure cases, but surgery remains as the gold standard treatment not only for the cases, which failed to be treated by less invasive approaches, but also in cases that are mandatory to be explored as peritonitis.