Comparative Study of Laparoscopic and Open Distal Pancreatectomy

Abstract

LDP appears to be a safe, desirable procedure for the management of benign pancreatic diseases, with outcomes similar to ODP.

Laparoscopic pancreatectomy: Indications and outcomes

“…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.…”

“…Although there is a lack of randomized trials comparing LDP and ODP, there have been many retrospective series in the past decade studying the post-operative outcomes of LDP ( Table 2). The main advantages of LDP include shorter hospital stay (difference of 2 d or more) [2][3][4][5][6]9,[11][12][13][14][15][16][19][20][21]23,24] , decreased requirement for pain medications, and swifter return to regular diet (difference of 1.7 d) [19] . The overall morbidity is approximately 26%-40% [2,10,11,13] , which is similar to ODP from contemporary series (29%-57%).…”

“…Aly et al [9] 22/27 a 0 20%/31% N/A 12%/17% 3/4 N/A N/A N/A DiNorcia et al [10] 5/6 a 0%/1% 28.2%/43.8% a 5.6%/3.6% 11.3%/14.1% 2.5/3.6 a 12.7%/38.5% a 2.8%/13% a 6/8 Jayaraman et al [11] 5/7 a 0%/0.8% 27%/40% a 2%/2% 15%/13% 3/3 a 17%/47% a 3%/4% 6/7 Kooby et al [12] 7.4/10.7 a N/A N/A N/A N/A 3.5/4.5 100%/100% 26%/27% 13.8/12.5 Vijan et al [13] 6.1/8.6 a 3%/1% 34%/29% N/A 17%/17% 3.3/4 a 23%/23% 0 NS Baker et al [14] 4.0/8. [15] 5.9/8.6 a 0%/4.8% NS N/A 50%/46% 3.26/7.73 a 25%/42% a 0 N/A Nakamura et al [16] 10/25.…”

“…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…”

Single-center experience of laparoscopic left pancreatic resection in 359 consecutive patients: changing the surgical paradigm of left pancreatic resection

“…Compared with open distal pancreatectomy (ODP), LDP has shown improved perioperative outcomes, including reduced postoperative pain, fewer wound-related problems, faster recovery, and shorter hospital stay, whereas blood loss, operation time, and rates of postoperative complications, including pancreatic fistula, were similar [11][12][13][14][15][16][17][18][19][20][21].…”