Left-sided pancreatic incidentalomas treated with laparoscopic approach: a report of 20 cases

BACKGROUND: The diffusion of cross-sectional imaging has recently permitted the detection of an increasing number of incidentalomas localized in the distal pancreas. Currently, there are no studies in the literature exploring the laparoscopic approach as treatment for left-sided pancreatic incidentalomas. METHODS AND RESULTS: We report a series of 20 incidentalomas localized in the body and tail of the pancreas treated with laparoscopic surgery over the period 2010–2014. The incidental masses of our series included a great variety of histotypes and a relevant proportion of malignant lesions. In two cases, the laparoscopic procedures were converted to open surgery. No postoperative death was observed. The postoperative pancreatic fistula rate was 20 %, and the new-onset diabetes rate was 25 %. CONCLUSIONS: Left-sided pancreatic incidentalomas in patients with minor comorbidities can be safely treated with laparoscopic approach. Only clinical trials will confirm whether laparoscopic surgery is an effective treatment for malignant lesions.