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Comparative Study
. 2017 Jun;18(6):532-538.
doi: 10.1631/jzus.B1600541.

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Ai-Bin Zhang  1 , Ye Wang  1 , Chen Hu  1 , Yan Shen  1 , Shu-Sen Zheng  1
Affiliations
Comparative Study

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Ai-Bin Zhang et al. J Zhejiang Univ Sci B. 2017 Jun.

Abstract

Objective: The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) at a single center.

Methods: Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted.

Results: Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by ODP. No patients with locally advanced lesions were included in this study. Comparing LDP group to ODP group, there were no significant differences in operation time (P=0.06) or blood loss (P=0.24). Complications (pancreatic fistula, P=0.62; intra-abdominal abscess, P=0.44; postpancreatectomy hemorrhage, P=0.34) were similar. There were no significant differences in the number of lymph nodes harvested (11.2±4.6 in LDP group vs. 14.4±5.5 in ODP group, P=0.44) nor the rate of patients with positive lymph nodes (36% in LDP group vs. 41% in ODP group, P=0.71). Incidence of positive margins was similar (9% in LDP group vs. 13% in ODP group, P=0.61). The mean overall survival time was (29.6±3.7) months for the LDP group and (27.6±2.1) months for ODP group. There was no difference in overall survival between the two groups (P=0.34).

Conclusions: LDP is a safe and effective treatment for selected patients with pancreatic ductal adenocarcinoma. A slow-compression of pancreas tissue with the GIA stapler is effective in preventing postoperative pancreatic fistula. The oncologic outcome is comparable with the conventional open approach. Laparoscopic radical antegrade modular pancreatosplenectomy contributed to oncological clearance.

Keywords: Laparoscopic distal pancreatectomy; Open distal pancreatectomy; Pancreatic neoplasm; Pancreatic fistula.

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Conflict of interest statement

Compliance with ethics guidelines: Ai-bin ZHANG, Ye WANG, Chen HU, Yan SHEN, and Shu-sen ZHENG 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.

Figures

Fig. 1
Fig. 1
Overall survival of patients undergoing LDP and ODP
See this image and copyright information in PMC

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References

    1. Adsay NV, Basturk O, Altinel D, et al. The number of lymph nodes identified in a simple pancreatoduodenectomy specimen: comparison of conventional vs orange-peeling approach in pathologic assessment. Mod Pathol. 2009;22(1):107–112. doi: 10.1038/modpathol.2008.167. - DOI - PMC - PubMed
    1. Baker MS, Bentrem DJ, Ujiki MB, et al. A prospective single institution comparison of peri-operative outcomes for laparoscopic and open distal pancreatectomy. Surgery. 2009;146(4):635–645. doi: 10.1016/j.surg.2009.06.045. - DOI - PubMed
    1. Bassi C, Dervenis C, Butturini G, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138(1):8–13. doi: 10.1016/j.surg.2005.05.001. - DOI - PubMed
    1. Briggs CD, Mann CD, Irving GR, et al. Systematic review of minimally invasive pancreatic resection. J Gastrointest Surg. 2009;13(6):1129–1137. doi: 10.1007/s11605-008-0797-z. - DOI - PubMed
    1. de Rooij T, Tol JA, van Eijck CH, et al. Outcomes of distal pancreatectomy for pancreatic ductal adenocarcinoma in the netherlands: a nationwide retrospective analysis. Ann Surg Oncol. 2016;23(2):585–591. doi: 10.1245/s10434-015-4930-4. - DOI - PMC - PubMed

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