A Multicenter Analysis of Distal Pancreatectomy for Adenocarcinoma: Is Laparoscopic Resection Appropriate?

Kooby, David A.; Hawkins, William G.; Schmidt, C. Max; Weber, Sharon M.; Bentrem, David J.; Gillespie, Theresa W.; Sellers, Johnita Byrd; Merchant, Nipun B.; Scoggins, Charles R.; Martin, Robert C.G.; Kim, Hee Jin; Ahmad, Syed A.; Cho, Clifford S.; Parikh, Alexander A.; Chu, Carrie K.; Hamilton, Nicholas A.; Doyle, Courtney; Pinchot, Scott N.; Hayman, Amanda V.; McClaine, Rebecca J.; Nakeeb, Attila; Staley, Charles A.; McMasters, Kelly M.; Lillemoe, Keith D.

doi:10.1016/j.jamcollsurg.2009.12.033

Cited by 300 publications

(263 citation statements)

References 21 publications

Supporting

Mentioning

232

Contrasting

Unclassified

Order By: Relevance

“…This suggests that laparoscopic PD is effective for oncologic resection. This has been corroborated by several studies [8,21,22,25,26]. The R0 rates found in this study (15/22 and 8/10) and the median harvested lymph nodes (16 and 14) are well in line with other previously published data.…”

Section: Discussionsupporting

confidence: 93%

Short-term outcomes after distal pancreatectomy: Laparotomy vs. laparoscopy – A single-center series

et al. 2016

View full text Add to dashboard Cite

h i g h l i g h t sLaparoscopy has been recently used more frequently for distal pancreatectomy. Postoperative complications and oncologic outcomes were similar in this study. Length of stay was shorter for the patients operated by laparoscopy. Laparoscopy should be offered when technically feasible. a r t i c l e i n f o Conclusion: Short-term outcomes after open and laparoscopic distal pancreatectomy regarding postoperative complications and mortality were similar, but length of stay was significantly shorter for the laparoscopic approach. Hence, laparoscopic distal pancreatectomy should be offered to all suitable patients.

show abstract

Section: Discussionsupporting

confidence: 93%

Short-term outcomes after distal pancreatectomy: Laparotomy vs. laparoscopy – A single-center series

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Some series report a shorter operating time for LDPs compared to ODP [10,15,23] , but some of the studies' calculation of the average LDP operating time does not include the converted cases, which are much longer [10,15] . Other series reported equivalent or longer operating time with LDP compared to ODP [9,11,12] . One may note that the operating time is variable even though the surgical techniques are similar.…”

Section: Surgical Technique and Intra-operative Considerationsmentioning

confidence: 95%

“…Patient factors, such as body habitus, cardiopulmonary comorbidity, and a history of previous laparotomy are typical factors that may make laparoscopic surgery more challenging. High BMI is not a contraindication for LDP, nor is the size of the tumour being resected [8,11,12,26] . The laparoscopic approach may be even more beneficial in patients with higher BMI because of better access into the deep abdomen, less post-operative incisional pain and faster postoperative recovery.…”

Section: Patient Selectionmentioning

confidence: 99%

“…A LDP that is not converted to open is associated with significantly less intra-operative blood loss compared to ODP in many series [2,[4][5][6][10][11][12]14,16,21,23] . The usual rate of conversion to ODP is about 10%-20% (Table 1), but can be over 25% in series with less selected patients [11,32] .…”

Section: Surgical Technique and Intra-operative Considerationsmentioning

confidence: 99%

“…As a result, the application of laparoscopy to pancreatectomy has been slower compared to other abdominal procedures. As surgeons become more adept at advanced laparoscopy, there is increasing evidence demonstrating not only the safety and feasibility of laparoscopic pancreatic [3] 42/76 27.3/26.5 NS 35.7%/22.4% 304/281 375/375 11.9% Mehta et al [4] 30/30 N/A N/A 70%/30% a 188/226 294/729 a N/A Limongelli et al [5] 16/29 26.4/27.1 NS 31%/14% 204/160 a 160/365 a 6.0% Soh et al [6] 10/21 25/21 NS N/A 383/330 275/600 a N/A Butturini et al [7] 43/73 N/A N/A 44.2%/11% a 180/180 N/A 0.0% Cho et al [8] 254/439 NS NS 34%/10% a NS 24%/54% (> 300cc) 9.4% Aly et al [9] 40/35 21/21 N/A 32%/8% a 342/250 a 363/606 a 10.0% DiNorcia et al [10] 71/192 N/A NS 15.5%/15.6% 250/270 a 150/900 a 25.3% Jayaraman et al [11] 107/236 27/27 N/A 21%/14% 194/163 a 150/350 a 30.0% Kooby et al [12] 23/189 28.5/26.2 NS N/A 238/230 422/790 a 17.0% Vijan et al [13] 100/100 27.4/27.9 NS 25%/N/A 214/208 171/519 a 4.0% Baker et al [14] 27/85 N/A NS N/A 236/253 219.4/612.6 a 3.6% Finan et al [15] 44/104 28.3/26.9 NS 2%/2.7% 156/200 a 157/719 a 4.1% Nakamura et al [16] 21 [17] 7/4 29.5/29 N/A 100%/100% 182/152 214/362 0.0% Eom et al [18] 31 [19] 93 [20] 14/19 N/A NS N/A 290.7/213.8 a 247.1/400.3 7.0% Misawa et al [21] 8/9 N/A N/A 12.5%/0% 255/205 14/307 a 0.0% Tang et al [22] 9/5 N/A NS 55.6%/0% 180/210 100/450 a 0.0% Teh et al [23] 12 [24] 15/15 N/A N/A 0%/0% N/A N/A 20.0% Fernández-Cruz et al [25] 5/41…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

View full text Add to dashboard Cite

The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and shortterm oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. Key words: Laparoscopy; Distal pancreatectomy; Pancreaticoduodenectomy; Robotic pancreatectomy; Enucleation Core tip: This review discusses recent advances in laparoscopic distal pancreatectomy (LDP), minimally invasive pancreaticoduodenectomy (MIPD), and enucleation. Recent studies show that LDP have improved perioperative recovery and equivalent oncologic outcomes. Studies on MIPD demonstrate that it is safe in terms of intra-operative outcomes, post-operative recovery and early oncologic outcomes; however, it requires advanced laparoscopic skills. Laparoscopic enucleation has become the operation of choice for small benign tumours that are away from the main pancreatic duct, especially insulinomas. We also summarize key results in pre-operative, perioperative and post-operative outcomes from contemporary series comparing open and laparoscopic pancreatic resections in the tables.

show abstract

Comparative Effectiveness of Minimally Invasive and Open Distal Pancreatectomy for Ductal Adenocarcinoma

et al. 2013

View full text Add to dashboard Cite

show abstract

A Multicenter Analysis of Distal Pancreatectomy for Adenocarcinoma: Is Laparoscopic Resection Appropriate?

Cited by 300 publications

References 21 publications

Short-term outcomes after distal pancreatectomy: Laparotomy vs. laparoscopy – A single-center series

Short-term outcomes after distal pancreatectomy: Laparotomy vs. laparoscopy – A single-center series

Laparoscopic pancreatectomy: Indications and outcomes

Comparative Effectiveness of Minimally Invasive and Open Distal Pancreatectomy for Ductal Adenocarcinoma

Contact Info

Product

Resources

About