Open Distal Pancreatectomy

Historically, references to distal pancreatectomy (DP) date back to the late 1800s. Billroth is said to have performed resections of both the head and tail of the pancreas in 1884, but Trendelenburg supposedly preceded this feat by 2 years when he performed a DP with splenectomy for a sarcoma. However, the patient did not survive past the first postoperative day [1]. Still, DP was not performed with regularity for nearly a century thereafter. Among the many reasons were the paucity of obvious presenting symptoms for conditions of the distal pancreas, the inaccuracy of staging malignancies, difficulty in exposing the retroperitoneum, and excessively high morbidity and mortality rates. Interestingly, neuroendocrine diseases presented early opportunities for advancement, and Finney and Mayo published some of the first successful case reports [2, 3].