Laparoscopic distal pancreatectomy for pancreatic cancer is safe and effective

Bauman, Marita D.; Becerra, David; Kilbane, E. Molly; Zyromski, Nicholas J.; Schmidt, C. Max; Pitt, Henry A.; Nakeeb, Attila; House, Michael G.; Ceppa, Eugene P.

doi:10.1007/s00464-017-5633-7

Cited by 40 publications

(30 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In a propensity score matched analysis of laparoscopic (n=51) versus open (n=51) DP for pancreatic cancer, there was no significant difference in the rate of POPF (10% vs 19%, respectively, p >0.05). 100 This is consistent with findings from another retrospective analysis of laparoscopic (n=33) versus open (n=46) DP for pancreatic cancer (POPF rates 9% vs 15%, respectively, p =0.42). 101 In an analysis of ACS-NSQIP data for 1815 patients who underwent open (n=921), laparoscopic (n=694), or robotic (n=200) DP, no difference was seen in the rates of POPF (17% vs 18% vs 21%, respectively, p =0.6484).…”

Section: Traditional Conceptssupporting

confidence: 90%

Postoperative pancreatic fistula: a review of traditional and emerging concepts

Nahm¹,

Connor²,

Samra³

et al. 2018

CEG

148

125

View full text Add to dashboard Cite

Postoperative pancreatic fistula (POPF) remains the major cause of morbidity after pancreatic resection, affecting up to 41% of cases. With the recent development of a consensus definition of POPF, there has been a large number of reports examining various risk factors, prediction models, and mitigation strategies for this costly complication. Despite these strategies, the rates of POPF have not significantly diminished. Here, we review the literature and evidence regarding both traditional and emerging concepts in POPF prediction, prevention, and management. In particular, we review the evidence for the association between postoperative pancreatitis and POPF, and present a novel proposed mechanism for the development of POPF.

show abstract

Section: Traditional Conceptssupporting

confidence: 90%

Postoperative pancreatic fistula: a review of traditional and emerging concepts

Nahm¹,

Connor²,

Samra³

et al. 2018

CEG

148

125

View full text Add to dashboard Cite

show abstract

“…Positive lymph nodes were reported in four studies 16,26,36,56 ; however, no significant difference was found in this outcome between the two groups (OR: 0.95, 95% CI: 0.69, 1.31; P = 0.76). The rate of the recurrence was not significantly different (OR: 0.74, 95% CI: 0.47, 1.18; P = 0.21) between groups according to the pooled results of 4 studies 17,26,37,59 . Unfortunately, only one study reported multivisceral resection, and no difference (ODP: −32.1% vs MIDP: −38.6%, P = 0.66) was found between the two groups.…”

Section: Resultsmentioning

confidence: 89%

The oncological safety in minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis

Yang

Xiong

et al. 2019

Sci Rep

View full text Add to dashboard Cite

The safety of minimally invasive distal pancreatectomy (MIDP) and open distal pancreatectomy (ODP) regarding oncological outcomes of pancreatic ductal adenocarcinoma (PDAC) remains inconclusive. Therefore, the aim of this study was to examine the oncological safety of MIDP and ODP for PDAC. Major databases including PubMed, Embase, Science Citation Index Expanded, and the Cochrane Library were searched for studies comparing outcomes in patients undergoing MIDP and ODP for PDAC from January 1994 to August 2018. In total, 11 retrospective comparative studies with 4829 patients (MIDP: 1076, ODP: 3753) were included. The primary outcome was long-term survival, including 3-year overall survival (OS) and 5-year OS. The 3-year OS (hazard ratio (HR): 1.03, 95% confidence interval (CI): 0.89, 1.21; P = 0.66) and 5-year OS (HR: 0.91, 95% CI: 0.65, 1.28; P = 0.59) showed no significant differences between the two groups. Furthermore, the positive surgical margin rate (weighted mean difference (WMD): 0.71, 95% CI: 0.56, 0.89, P = 0.003) was lower in the MIDP group. However, patients in the MIDP group had less intraoperative blood loss (WMD: −250.03, 95% CI: −359.68, −140.39; P < 0.00001), a shorter hospital stay (WMD: −2.76, 95% CI: −3.73, −1.78; P < 0.00001) and lower morbidity (OR: 0.57, 95% CI: 0.46, 0.71; P < 0.00001) and mortality (OR: 0.50, 95% CI: 0.31, 0.81, P = 0.005) than patients in the ODP group. The limited evidence suggested that MIDP might be safer with regard to oncological outcomes in PDAC patients. Therefore, future high-quality studies are needed to examine the oncological safety of MIDP.

show abstract

“…While LDP should theoretically provide the same postoperative recovery advantages reputed to minimal access surgery, there have been fears as to the safety of LDP in terms of life-threatening intra-operative events and postoperative complications, adequate carcinological outcomes as compared to traditional (open) distal pancreatectomy (ODP) when performed for cancer (6), as well as to whether the laparoscopic approach is well adapted to the variety of diseases that may affect the pancreas (ranging from trauma to benign or malignant disease) and whether the minimal access approach is well adapted to perform pancreatic surgery safely in the obese, the elderly or the frail.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic distal pancreatectomy: better than open?

Fingerhut¹,

Uranues²,

Khatkov³

et al. 2018

Transl. Gastroenterol. Hepatol.

View full text Add to dashboard Cite

Distal pancreatectomy is well suited to the laparoscopic approach. Laparoscopic distal pancreatectomy (LDP) provides the same postoperative recovery advantages reputed to minimal access surgery. However, there have been fears as to the safety of LDP in terms of life-threatening intra-operative events and post-operative complications, adequate carcinological outcomes as compared to traditional (open) distal pancreatectomy (ODP) when performed for cancer, as well as to whether the laparoscopic approach is well adapted to the variety of diseases that may affect the pancreas (ranging from trauma to benign or malignant disease) and whether the minimal access approach is well adapted to perform pancreatic surgery safely in the obese, the elderly or the frail. In this review of the literature, we sought to determine whether LDP was as safe, provided the same oncological outcomes and was applicable to all diseases involving the body and tail of the pancreas, and to particular patient characteristics, compared to the traditional open approach. Last we looked at cost issues. We concluded that this review of the literature allowed to state that laparoscopic distal pancreatectomy is feasible and safe for a wide range of diseases, both benign and malignant. Morbidity, mortality, and probably, also, carcinological outcomes are comparable to open surgery. The overall costs are similar but the advantages of minimal access surgery make it the preferred approach, once the surgical expertise is acquired and present.

show abstract

Laparoscopic distal pancreatectomy for pancreatic cancer is safe and effective

Abstract: The results of this series suggest that LDP is a safe surgical approach that is comparable from an oncologic standpoint to ODP for the management of pancreatic adenocarcinoma.

Cited by 40 publications

References 29 publications

Postoperative pancreatic fistula: a review of traditional and emerging concepts

Postoperative pancreatic fistula: a review of traditional and emerging concepts

The oncological safety in minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis

Laparoscopic distal pancreatectomy: better than open?

Contact Info

Product

Resources

About