Comparison of Laparoscopy and Exploration in the Distal Pancreatectomy.
- Author:
Ji Woong HWANG
1
;
Song Cheol KIM
;
Kwan Tae PARK
;
Haeng Chul SHIN
;
Duck Jong HAN
Author Information
1. Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. drksc@amc.seoul.k
- Publication Type:Original Article
- Keywords:
Laparoscopy;
Open;
Distal pancreatectomy
- MeSH:
Chungcheongnam-do;
Diet;
Humans;
Laparoscopy*;
Length of Stay;
Operative Time;
Pancreas;
Pancreatectomy*;
Pancreatic Diseases;
Pancreatic Fistula;
Postoperative Complications;
Retrospective Studies
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2007;11(4):77-84
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: To determine the benefits of laparoscopic surgery compared with exploration, the clinical outcomes of open and laparoscopic distal pancreatectomy were compared. METHOD: From March 2005 to June2007, we studied 95 patients at Asan Medical Center. These patients had benign pancreatic disease in the distal pancreas, e.g. a cystic neoplasm. These patients underwent a distal pancreatectomy with or without spleen-preservation using laparoscopic or exploration surgery. We divided these patients into two groups i.e. laparoscopy (n=60) and exploration (n=35), and compared the outcomes of the two groups retrospectively. RESULT: There was no difference in demographic features between the two groups. Laparoscopic resection required a median time of 208 mins, compared with 190 mins for the open resection. (p>0.05) The laparoscopic patients started a liquiddiet on postoperative day three, and required a median hospital stay of 11 days, compared with 4.5 days and 16 days for the open resection surgery, respectively. (p<0.001) The overall postoperative complication rate was 28.3% for the laparoscopic group compared with 22.9% for the open group. (p>0.05) The pancreatic fistula rate was lower in the laparoscopic patient group than in the open group. (8.3% vs. 14.3%) (p>0.05) The rate of spleen-preservation was higher in the laparoscopy group than the open group. (25% vs. 5.7%), (p>0.05) CONCLUSION: The results of this study showed that the laparoscopic distal pancreatectomy had a similar surgical time, an early start of the diet, a shorter hospital stay, and a higher spleensaving rate, compared to exploration surgery. Therefore, considering the benefits of laparoscopic surgery, it appears to be the preferred approach, with or without spleen-preservation, for treating benign distal pancreatic disease.
