A Nationwide Comparison of Laparoscopic and Open Distal Pancreatectomy for Benign and Malignant Disease

Rooij, Thijs de; Jilesen, Anneke P. J.; Boerma, Djamila; Bonsing, Bert A.; Bosscha, K.; Dam, Ronald M. van; Dieren, Susan van; Dijkgraaf, Marcel G. W.; Eijck, Casper H. van; Gerhards, Michael F.; Goor, Harry van; Harst, Erwin van der; Hingh, Ignace H. J. T. de; Kazemier, Geert; Klaase, Joost M.; Molenaar, I. Quintus; Dijkum, Els J. M. Nieveen van; Patijn, Gijs A.; Santvoort, Hjalmar C. van; Scheepers, Joris J.; Schelling, George P. van der; Sieders, Egbert; Vogel, Jantien A.; Busch, Olivier R.; Besselink, Marc G.

doi:10.1016/j.jamcollsurg.2014.11.010

Cited by 79 publications

(62 citation statements)

References 38 publications

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“…Although it is difficult to evaluate the influence of this procedure on outcome, we feel that our positive surgical and postoperative results are probably related in part to this maneuver. Compared to other series, our mean operative time was shorter for DP (174 vs. 193-239 min) [13][14][15] and the conversion rate was also very low (3 vs. 23-33%) [9,14,15] . A shorter mean operative time was also noted for CP (191 vs. 225-480 min) [16][17][18][19][20] as well as a very low conversion rate (3 vs. 17-22%) [16,17] .…”

Section: Discussioncontrasting

confidence: 60%

Hanging Maneuver for Stomach Traction in Laparoscopic Distal Pancreatic Resections: An Original Technique Applied in 218 Patients

et al. 2016

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Background: Stomach traction done to expose the pancreas is still a problem in laparoscopic left pancreatic resections. We developed a simple hanging maneuver to retract the stomach rapidly and effectively. Methods: After dividing the gastrocolic ligament, the stomach was encircled with a tape, turned along its horizontal axis and pulled with an epigastric trocar, which was later removed. This technique was used in all patients who underwent laparoscopic left pancreatic resections including 165 distal pancreatectomies (DP), 35 central pancreatectomies (CP) and 18 enucleations (En). Demographics, surgical and postoperative outcome data were recorded. Results: There were no mortalities. The mean operative time for DP, CP and En were 174, 191 and 104 min, respectively. The transfusion (0-4%) and conversion (0-3%) rates were low for all procedures. Morbidity was mainly represented by pancreatic fistula and grades (B + C) for DP, CP and En were observed in 26, 22 and 17%, respectively. No complication related to hanging of the stomach, like gastric perforation, was observed. Re-intervention and the mean hospital stay for DP, CP and En were observed in 5, 11 and 0% and were 16, 22 and 12, respectively. The readmission rate was low (0-9%). Conclusions: Hanging maneuver of the stomach is a simple procedure to rapidly, safely and effectively retract the stomach during left laparoscopic pancreatic resections.

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Section: Discussioncontrasting

confidence: 60%

Hanging Maneuver for Stomach Traction in Laparoscopic Distal Pancreatic Resections: An Original Technique Applied in 218 Patients

et al. 2016

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“…Several retrospective, single-center and multicenter studies have compared the outcomes between LDP and open distal pancreatectomy (ODP) [2,3,28,42,[64][65][66][67][68][69][70][71][72][73][74]. They indicated the superiority of LDP regarding blood loss, postoperative complications, such as surgical site infections, the recovery of physical function, and postoperative hospital stay.…”

Section: Laparoscopic Operationsmentioning

confidence: 99%

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

et al. 2016

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Postoperative pancreatic fistula (POPF) is the most frequent and serious complication after distal pancreatectomy (DP) and often leads to other postoperative complications. Numerous studies have been conducted to clarify the risk factors for POPF after DP, and to also determine effective prophylactic treatments. In this article, we review the current evidence on the risk factors for POPF after DP, and also provide new evidence to support the currently implemented prophylactic measures against POPF after DP. The patient-related and surgery-related risk factors and risk factors specific to staplers are discussed. Several studies have suggested that a thick pancreas is a risk factor for POPF using a stapler and that a higher stapler height or pancreatoenteric anastomosis might be useful for preventing POPF when transecting a thick pancreas. Various methods, such as stapler closure, procedures that may be performed in addition to stapler closure, pancreatoenteric anastomosis, pancreatic transection devices, laparoscopic surgery, pancreatic stenting, stump coverage, and somatostatin analogs, have been tested and in comparison with conventional procedures in case-control studies and randomized, controlled trials. Although some studies have shown the superiority of these methods to the conventional procedures, a consensus on precautionary measures that can be taken against POPF remains to be established. Further investigation is necessary to develop a reliable strategy for preventing POPF and to improve the outcomes of patients after DP.

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“…According to all these above-mentioned consideration, it seems clear that, in order to demonstrate the superiority of LDP compared to ODP, particularly in terms of oncological results, it is time to randomize. Two recent important national observational studies, published by French and Dutch groups [27,28], confirmed this necessity; only a multicentric randomized control trial could provide the superiority of LDP, if compared with ODP.…”

Section: Minimally Invasive Dpmentioning

confidence: 99%

Minimally Invasive Pancreatic Resection: Is It Really the Future?

et al. 2016

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The introduction and widespread application of minimally invasive surgery has been one of the most important innovations that radically changed the practice of surgery during the last few decades. The application to pancreatic surgery of minimally invasive approach has only recently emerged: both laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreaticoduodenectomy (LPD) can be competently performed. LDP and LPD are advocated to improved perioperative outcomes, including decreased blood loss, shorter length of stay, reduced postoperative pain and expedited time to functional recovery. However, the indication to minimally invasive approach for pancreatic surgery is often benign or low-grade malignant pathologies. In this review, we summarize the current data on minimally invasive pancreatic surgery, focusing on indication, perioperative and oncological outcomes.

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A Nationwide Comparison of Laparoscopic and Open Distal Pancreatectomy for Benign and Malignant Disease

Cited by 79 publications

References 38 publications

Hanging Maneuver for Stomach Traction in Laparoscopic Distal Pancreatic Resections: An Original Technique Applied in 218 Patients

Hanging Maneuver for Stomach Traction in Laparoscopic Distal Pancreatic Resections: An Original Technique Applied in 218 Patients

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

Minimally Invasive Pancreatic Resection: Is It Really the Future?

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