Short-term outcomes after distal pancreatectomy: Laparotomy vs. laparoscopy – A single-center series. (January 2017)

• Record Type: Journal Article
• Authors: Joliat, Gaëtan-Romain; Demartines, Nicolas; Halkic, Nermin; Petermann, David; Schäfer, Markus
• Is Part Of: Annals of medicine and surgery. Volume 13(2017)
• Page Start: 1
• Page End: 5
• Publication Date: 2017-01
• Subjects: Pancreatic surgery -- Distal pancreatectomy -- Laparoscopy -- Complications -- Length of stay; Surgery -- Periodicals; Medicine -- Periodicals; General Surgery -- Periodicals; Education, Medical -- Periodicals; Periodicals; 617
• DOI: 10.1016/j.amsu.2016.12.001
• Languages: English
• ISSNs: 2049-0801

Abstract

Abstract: Background: Laparoscopic distal pancreatectomy was introduced 15 years ago, but it is still not widely used. The aim of the study was to compare the postoperative complications and length of stay between open and laparoscopic distal pancreatectomy. Materials and methods: A search of our institutional pancreas database was performed. All consecutive distal pancreatectomy patients from 2000 to 2015 were identified. Demographics, peri- and postoperative outcomes were reviewed. Postoperative complications were graded using Clavien classification. Standard statistical analyses were performed. Results: One hundred and five patients underwent distal pancreatectomy (45 women, 60 men, median age of 63 years). Seventy-nine cases were performed open and 26 by laparoscopy (conversion rate from laparoscopy to laparotomy: 7/26). Characteristics of both groups were similar. The tumor proportion was similar in both groups (56/79 and 23/26, p = 0.114). Overall complication rate was 41/79 (52%) in the open group and 9/26 (36%) in the laparoscopy group (p = 0.175). Two patients died during hospital stay in the open group compared to 0 in the laparoscopy group (p = 1). The fistula rates were comparable (17/79 and 5/26, p = 1). Median length of stay was shorter for the laparoscopy group (8 vs. 12 days, p < 0.001), as well as the median intermediate care stay (1 vs. 3 days, p = 0.004). Conclusion: Short-term outcomes after open and laparoscopic distal pancreatectomy regarding postoperative complications and mortality were similar, but length of stay was significantly shorter for the laparoscopic approach. Hence, laparoscopic distal pancreatectomy should be offered to all suitable patients. Highlights: Laparoscopy has been recently used more frequently for distal pancreatectomy. Postoperative complications and oncologic outcomes were similar in this study. Length of stay was shorter for the patients operated by laparoscopy. Laparoscopy should be offered when technically feasible.