A Comparative Study of Laparoscopic vs Open Distal Pancreatectomy for Left-Sided Ductal Adenocarcinoma: A Propensity Score-Matched Analysis

Laparoscopic pancreatic resection—a review

“…Of note, DOS after DP seemed to be shorter in the United States compared to centers outside of the United States, which might be attributed to differences in health care systems (18). More recently, Shin and colleagues (12) confirmed these reductions in their single center, propensity matched analysis.…”

“…Indications include benign, pre-malignant and malignant lesions of the pancreatic body/tail such as chronic pancreatitis, endocrine tumors, intraductal papillary mucinous neoplasm (IPNM), pancreatic pseudocysts, mucinous and serous cystic neoplasia, metastases and also trauma with ductal injury (9)(10)(11). MAS accounts for between 10.8% to 46.6% of DP (9,12,13). Several publications have found no statistically significant difference in operative times between laparoscopic DP (LDP) and open DP (ODP), ranging from 156 to 383 min and from 145 to 330 min in laparoscopic and open surgery, respectively (14)(15)(16)(17).…”

Laparoscopic distal pancreatectomy

“…Trocar site metastasis, promotion of neoplastic growth by pneumoperitoneum, and wound recurrence have not been proven to be risks of LDP (14,15). However, no evidence has been presented in the literature that the use of the laparoscopic technique increases the risk of neoplastic dissemination, and none of the patients in recent studies developed any trocar site or peritoneal metastasis (4,(16)(17)(18)(19). The results described above show that there is no exact preoperative indication for ODP or LDP.…”

“…Use of the RAMPS approach can increase R0 rates. The RAMPS technique has been adopted for laparoscopic surgery and is an option for the laparoscopic resection of distal pancreatic adenocarcinomas (19,23). Advanced laparoscopic operations, such as RAMPS can be easily performed.…”

“…Also, additional organ resections are not contraindications to LDP. Colectomy, gastrectomy, cholecystectomy, and repair of colovesical fistulas have been laparoscopically performed with LDP (19,24).…”