When the tumor is located in the left side of the pancreas, a distal or caudal pancreatectomy is considered. Often the tumors that arise in the left region of the pancreas are diagnosed at a very late stage when metastasis has already occurred.
Resection is a possibility only if the tumor is localised and the celiac axis, the superior mesenteric arteries are not involved. Involvement of splenic vessels is not a contraindication for resection.
The entire pancreatic body and tail has to be assessed along with the assessment of celiac axis, periaortic region and the peritoneum.
The spleen is resected in most of the cases after ligating the splenic artery: removal of the spleen assists dissection of the tail. In small and more indolent tumors, spleen resection is a well described procedure with documented benefits.
The left sided tumors are typically larger in size and lymph nodes are involved to a lesser extent as compared to the right sided tumors.