부산대학교 도서관

BACKGROUND: Pancreatic fistula after distal pancreatectomy remains an unsolved problem, ranging in frequency between 15% and 40%, regardless of whether the intervention is performed laparoscopically or by open surgery. METHODS: Herein, presenting the case of a 68-year-old woman with a functioning insulinoma submitted to laparoscopic spleen preserving distal pancreatectomy, we propose a new technique of pancreatic transection by the LigaSure system, which seals vessels and other tubular structures by reforming parietal collagen and elastin. RESULTS: The patient had a favorable outcome. The reported technique presents the advantages of an easy employ and of a contemporary hemostasis, thus being particularly suitable by the laparoscopic way, and may offer from a theoretical point of view some advantages over conventional pancreatic stump closure techniques in terms of fistula formation. CONCLUSIONS: Laparoscopic pancreatic transection by LigaSure may prove useful, safe, and effective. A prospective clinical study has now been designed to confirm such hypothesis. SHORT SUMMARY: A simple and safe technique for pancreas neck transection, particularly suitable for laparoscopic left pancreatectomy, is described.