Total pancreatectomy: doing it with a mini-invasive approach.

OBJECTIVE: Pancreatic laparoscopic surgery represents one of the most discussed and demanding fields in surgery. Total pancreatectomy is considered to a viable option for treating both benign and malignant pathologies of the pancreas and, thanks to the introduction of laparoscopic techniques for pancreatic resections into clinical practice, it can be performed nowadays with a less invasive approach. CASE REPORT: We report the case of a combined total pancreatectomy, consisting of a totally laparoscopic body-tail mobilization followed by the opening of a right subcostal mini-laparotomy in order to perform a pancreaticoduodenectomy and a reconstructive phase. DISCUSSION: This technique represents the result of experience acquired in the last decade in the field of advanced laparoscopic pancreatic surgery. It consists of a widely accepted laparoscopic splenopancreatectomy and of a traditional pancreaticoduodenectomy which nowadays is considered safer and less time-consuming than the experimental laparoscopic one.