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Comparative Study
. 2015 Jul;16(7):573-9.
doi: 10.1631/jzus.B1400257.

Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study

Jia-fei Yan  1 , Tian-tao Kuang, Da-yong Ji, Xiao-wu Xu, Dan-song Wang, Ren-chao Zhang, Wei-wei Jin, Yi-ping Mou, Wen-hui Lou
Affiliations
Comparative Study

Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study

Jia-fei Yan et al. J Zhejiang Univ Sci B. 2015 Jul.

Abstract

Objective: To compare the peri-operative outcomes for laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for benign or premalignant pancreatic neoplasms in two institutions.

Methods: This prospective comparative study included 91 consecutive patients who underwent LDP (n=45) or ODP (n=46) from Jan. 2010 to Dec. 2012. Demographics, intra-operative characteristics, and post-operative outcomes were compared.

Results: The median operating time in the LDP group was (158.7±38.3) min compared with (92.2±24.1) min in the ODP group (P<0.001). Patients had lower blood loss in LDP than in the ODP ((122.6±61.1) ml vs. (203.1±84.8) ml, P<0.001). The rates of splenic conservation between the LDP and ODP groups were similar (53.3% vs. 47.8%, P=0.35). All spleen-preserving distal pancreatectomies were conducted with vessel preservation. LDP also demonstrated better post-operative outcomes. The time to oral intake and normal daily activities was faster in the LDP group than in the ODP group ((1.6±0.5) d vs. (3.2±0.7) d, P<0.01; (1.8±0.4) d vs. (2.1±0.6) d, P=0.02, respectively), and the post-operative length of hospital stay in LDP was shorter than that in ODP ((7.9±3.8) d vs. (11.9±5.8) d, P=0.006). No difference in tumor size ((4.7±3.2) cm vs. (4.5±1.8) cm, P=0.77) or overall pancreatic fistula rate (15.6% vs. 19.6%, P=0.62) was found between the groups, while the overall post-operative complication rate was lower in the LDP group (26.7% vs. 47.8%, P=0.04).

Conclusions: LDP is safe and effective for benign or premalignant pancreatic neoplasms, featuring lower blood loss and substantially faster recovery.

Keywords: Distal pancreatic resection; Laparoscopy; Pancreatic benign tumors; Pancreatic neoplasm; Splenic preservation.

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Conflict of interest statement

Compliance with ethics guidelines: Jia-fei YAN, Tian-tao KUANG, Da-yong JI, Xiao-wu XU, Dan-song WANG, Ren-chao ZHANG, Wei-wei JIN, Yi-ping MOU, and Wen-hui LOU declare that they have no conflict of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

References

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