Comparison of Laparoscopic and Open Distal Pancreatectomy with Focus on the Development of Postoperative Pancreatic Fistula.
- Author:
Hojong PARK
1
;
Yang Won NAH
;
Chang Woo NAM
;
Sung Jo BANG
Author Information
1. Department of Surgery, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea. nahyw@uuh.ulsan.kr
- Publication Type:Original Article
- Keywords:
Laparoscopic distal pancreatectomy;
Pancreatectomy;
Pancreas neoplasm
- MeSH:
Adenocarcinoma;
Body Mass Index;
Hemorrhage;
Humans;
Incidence;
Intestinal Obstruction;
Length of Stay;
Meals;
Pancreas;
Pancreatectomy;
Pancreatic Fistula;
Pancreatic Neoplasms;
Postoperative Complications
- From:Journal of the Korean Society of Endoscopic & Laparoscopic Surgeons
2011;14(2):42-50
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: To assess the technical feasibility of laparoscopic distal pancreatectomy (LDP) focusing on the development of postoperative complications including pancreatic fistula (POPF). METHODS: From March 2001 to April 2010, 57 patients underwent a distal pancreatectomy. The patients were divided into two groups, LDP group (L group, n=15) and open distal pancreatectomy group (O group, n=42). The clinicopathological characteristics, surgical variables and postoperative outcomes of these 2 groups were compared retrospectively. RESULTS: Patients with a malignancy constituted 7% of the L group and 31% of the O group (p=0.084). The tumor size was significantly larger in the O group (2.6 vs. 5.3 cm). The body mass index (BMI) was significantly higher in the L group (24.9 vs. 22.9 kg/m2). One case of a pancreas pseudocyst in the L group was converted to open surgery due to intraoperative bleeding. The L group showed significantly less intraoperative bleeding, earlier start of solid meals and shorter hospital stay. There was no significant difference in the incidence of postoperative complications and POPF between the 2 groups. POPF of ISGPF grade B developed in 0 and 2 patients in the L group and O group, respectively. One intestinal obstruction and 1 fluid collection that required intervention was encountered in the O group. One patient with adenocarcinoma who underwent LDP was alive 25 months after surgery without recurrence. CONCLUSION: LDP provides the advantages of minimal access surgery with a comparable rate of POPF to ODP. LDP is considered suitable for benign and borderline-malignant pancreatic lesions.
