Laparoscopic Distal Pancreatectomy in Children: Four Cases and Review of the Literature

Abstract Introduction: Laparoscopy has been utilized for children with pancreatic masses and blunt transection. In this article, we report our technique and experience. Operative Technique: With supine positioning, an umbilical trocar and three 5-mm trocars are positioned across the epigastrium. The gastrocolic ligament is opened completely and the stomach is retracted superiorly. A vessel-sealing electrosurgical device is used to dissect along the inferior margin of the pancreas. Dissection proceeds proximally or distally, depending on the location of the pathology. The proximal pancreatic duct is oversewn or stapled closed. The distal pancreas is mobilized from the splenic vessels. If the vessels cannot be mobilized from the pancreas, they are divided and a laparoscopic splenectomy is performed. The specimen is removed through the umbilical trocar by using a retrieval bag. Drains are placed prior to closure. Case Experience: We report 4 cases: 2 with pseudopapillary tumors and 2 with traumatic injuries....