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Case Studies

Laparoscopic Distal Pancreatectomy with Splenic Preservation

A 75-year-old woman with a multicystic pancreatic body lesion suspicious for IPMN/MCN underwent Total Laparoscopic Distal Pancreatectomy with Splenic Preservation by Dr. Raman Garg at Bombay Gastro & Cancer Institute, Bathinda, preserving the spleen and its blood supply.

Dr. Raman Garg 14 July 2026

Dr. Raman Garg Successfully Performs Advanced Spleen-Preserving Pancreatic Surgery for a Complex Pancreatic Cystic Tumour

Pancreatic cystic neoplasms, including Intraductal Papillary Mucinous Neoplasms (IPMN) and Mucinous Cystic Neoplasms (MCN), require careful evaluation because some lesions have the potential to become cancerous. When symptomatic or associated with suspicious imaging features, surgical removal is often the recommended treatment.

Dr. Raman Garg, Senior Surgical Gastroenterologist, Hepatobiliary & Pancreatic (HPB) Surgeon, GI Cancer Surgeon, and Advanced Laparoscopic Surgeon, successfully performed a Total Laparoscopic Distal Pancreatectomy with Splenic Preservation—one of the most technically demanding operations in minimally invasive pancreatic surgery.

Patient Presentation

A 75-year-old female consulted Dr. Raman Garg with recurrent episodes of upper abdominal pain.

An MRI of the abdomen revealed a multicystic lesion involving the body of the pancreas, suspicious for either Intraductal Papillary Mucinous Neoplasm (IPMN) or Mucinous Cystic Neoplasm (MCN).

Considering the patient's symptoms and the possibility of malignant transformation, Dr. Raman Garg recommended definitive surgical management.

Advanced Laparoscopic Pancreatic Surgery by Dr. Raman Garg

The patient underwent a Total Laparoscopic Distal Pancreatectomy with Splenic Preservation.

Laparoscopic opening of the gastrocolic ligament to access the pancreas Laparoscopic release of adhesions to the posterior stomach wall

Using advanced minimally invasive techniques, Dr. Raman Garg removed the diseased distal pancreas while preserving the spleen and its vascular supply. Splenic preservation is particularly beneficial because it helps maintain the body's immune function and avoids the lifelong risks associated with splenectomy whenever it is safely feasible.

Mobilisation of the lower border of the pancreas showing the cystic lesion Splenic artery and splenic vein carefully preserved during laparoscopic distal pancreatectomy

The entire operation was completed laparoscopically through small keyhole incisions, minimizing surgical trauma and facilitating faster postoperative recovery.

Small laparoscopic port site incisions after distal pancreatectomy surgery

The procedure was successfully performed by Dr. Raman Garg at Bombay Gastro & Cancer Institute, Bathinda.

Excellent Postoperative Recovery

The patient had an uneventful recovery:

  • Early postoperative mobilization.
  • Gradual resumption of oral diet.
  • Minimal postoperative pain.
  • No major complications.
  • Discharged in satisfactory condition on the 6th postoperative day.

Why This Case Is Important

Laparoscopic distal pancreatectomy with splenic preservation is one of the most technically challenging procedures in hepatopancreatobiliary (HPB) surgery. It requires meticulous dissection around the splenic artery and vein while preserving adequate blood supply to the spleen.

This case is significant because it demonstrates:

  • Successful minimally invasive removal of a complex pancreatic cystic tumour.
  • Preservation of the spleen and splenic vessels.
  • Advanced laparoscopic pancreatic surgery through small incisions.
  • Excellent postoperative recovery in a 75-year-old patient.
  • Availability of highly specialized pancreatic surgery in Bathinda.

This case highlights the growing availability of advanced HPB and pancreatic surgery in the Malwa region, allowing patients to receive world-class treatment closer to home without travelling to distant tertiary centres.

Advanced Pancreatic and HPB Surgery by Dr. Raman Garg

Dr. Raman Garg is a leading Surgical Gastroenterologist, Hepatobiliary & Pancreatic (HPB) Surgeon, GI Cancer Surgeon, Advanced Laparoscopic Surgeon, and Colorectal Surgeon based in Bathinda, Punjab. He routinely performs laparoscopic distal pancreatectomy, spleen-preserving pancreatic surgery, and complex hepatopancreatobiliary (HPB) procedures, focusing on organ preservation and Enhanced Recovery After Surgery (ERAS) protocols.

Patients from Bathinda, Punjab, Haryana, Rajasthan, and neighbouring states seek treatment from Dr. Raman Garg for advanced pancreatic and hepatobiliary surgical care.

Consultant Surgeon: Dr. Raman Garg
Patient: 75-year-old Female
Diagnosis: Multicystic Lesion of the Body of Pancreas, Suspicious for IPMN or MCN
Procedure Performed: Total Laparoscopic Distal Pancreatectomy with Splenic Preservation
Outcome: Uneventful recovery; discharged on the 6th postoperative day following successful laparoscopic spleen-preserving pancreatic surgery.

About Dr. Raman Garg

Dr. Raman Garg is a Consultant Surgical Gastroenterologist, Advanced GI, Laparoscopic and HPB Surgeon at Bombay Gastro & Cancer Institute, Bathinda. He specializes in gastrointestinal cancer surgery, liver, pancreas and bile duct surgery, colorectal surgery, hernia surgery, upper GI surgery, emergency abdominal surgery, and advanced minimally invasive procedures.

Patient identity has been withheld to maintain confidentiality. This case is published solely for educational purposes and with due respect for patient privacy.

Dr Raman Garg
Dr. Raman Garg
Senior Surgical Gastroenterologist & Laparoscopic Surgeon
Bombay Gastro & Cancer Institute, Bathinda

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