Laparoscopic or open distal pancreatectomy for benign and malignant lesions of the pancreas?

Minimally-invasive techniques were adopted relatively late for pancreatic procedures due to their complexity. Today, minimally-invasive distal pancreatectomy is the procedure of choice for the treatment of benign or premalignant pancreatic lesions due to the advantages inherent to laparoscopy. Data on the efficacy of minimally-invasive distal pancreatectomy in oncologic surgery is still limited and larger prospective series are needed prior to its widespread use for the treatment of pancreatic cancer. This review addresses various aspects of distal pancreatectomy, with emphasis on recent developments and open controversies.