Laparoscopic versus open distal pancreatectomy: a systematic review of comparative studies

Jusoh, Asri Che; Ammori, Basil J.

doi:10.1007/s00464-011-2016-3

Cited by 136 publications

(81 citation statements)

References 31 publications

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“…There was no significant difference in operative time overall laparoscopic (groups 1 + 2) vs open (groups 3 + 4) or spleenpreserving versus spleen-sacrificing distal pancreatectomies. This is in agreement with some studies but a few have concluded differently [4,5,29].…”

Section: Discussionsupporting

confidence: 93%

“…Also extensive use of energy sources (ultrasonic, bipolar, LigasureR, ThunderbeatR) and staplers may have contributed. This may also explain over all less time in all distal pancreatectomy groups (mean ranges from 98 to 150) compared to more than 200 min in some studies [4,29]. There was no significant difference in operative time overall laparoscopic (groups 1 + 2) vs open (groups 3 + 4) or spleenpreserving versus spleen-sacrificing distal pancreatectomies.…”

Section: Discussionmentioning

confidence: 88%

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Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

et al. 2015

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We analyzed perioperative outcome of distal pancreatectomies with or without splenic preservation both in laparoscopic and open method to determine best approach. Retrospective data was collected from 1999 to 2013. We divided all distal pancreatectomies into four groups. Group 1-laparoscopic spleen-preserving distal pancreatectomy (LSPDP). Group 2-laparoscopic splenectomy + distal pancreatectomy (LSDP). Group 3-open spleen-preserving distal pancreatectomy. Group 4-open splenectomy + distal pancreatectomy. We recorded demographic data, intra and post operative complications, operative time, estimated blood loss, length of stay, pancreatic leak rate, and final pathology result. A total of 38 distal pancreatectomies were included. In group 1, patients were significantly younger (mean 29 vs 47 to 50 in other groups, p=0.014). Tumor size (average 2.5 vs 5 to 9.5 cm in other groups, p=0.023) and operative time (average 98 min vs 125 to 141 in other groups, p=0.004) and hospital stay (average 6 vs 8 to 19 days in other groups, p=0.009) in LSPDP were all significantly less than other groups taken together. However, intra-operative blood loss was equivalent. We further analyzed that between LSPDP and LSDP, age and tumor size were significantly less in LSPDP. Further we analyzed between spleen-preserving (groups 1+3) vs spleensacrificing (groups 2+4) distal pancreatectomies and between overall laparoscopic (groups 1+2) vs open (groups 3+4). Laparoscopic spleen-preserving distal pancreatectomy has all the advantages of minimal access surgery especially in small lesions and low-grade malignancy.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 88%

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

et al. 2015

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“…LDP has rapidly expanded its application over the last decade and, although randomized studies are lacking, recent meta-analyses [2][3][4][5] have suggested that LDP was safe and effective as open distal pancreatectomy. Nevertheless, Rosales-Velderrain et al [6] have reported that, in the United States, only a low percentage (15%-27%) of patients with body/tail pancreatic tumors were subjected to LDP.…”

Section: Discussionmentioning

confidence: 99%

“…[1] Recent systematic reviews and meta-analyses [2][3][4][5] have demonstrated the safety and feasibility of LDP for benign and malignant pancreatic lesions and have reported postoperative outcome advantages with respect to an open approach.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic distal pancreatectomy in Italy: a systematic review and meta-analysis

Ricci

Casadei

Lazzarini

et al. 2014

Hepatobiliary & Pancreatic Diseases International

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“…Laparoscopic distal pancreatectomy (LDP) is gradually becoming the gold standard treatment for benign and malignant neoplasms in the body and tail of the pancreas [1,2]. Traditionally, splenectomy was performed in association with LDP because the spleen lies adjacent to the tail of pancreas and shares the same blood supply.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Laparoscopic Distal Pancreatectomy with or without Splenic Preservation

Jiang

Wang

et al. 2013

Indian J Surg

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Laparoscopic distal pancreatectomy (LDP) has gained large popularity in recent years, although the choice of whether to preserve the spleen has remained inconsistent. The aim of our study was to report our experiences with LDP and to provide evidence for the safety of the operative technique and an evaluation index of splenic function. We retrospectively evaluated all LDPs performed at our institution between March 2008 and February 2012. Cases were divided into a laparoscopic spleen-preserving distal pancreatectomy (LSPDP) group (n = 14) and an LDP with splenectomy (LDPS) group (n =19). Parametric and nonparametric statistical analyses were used to compare perioperative and oncologic outcomes. Demographic characteristics, operating time, length of stay, estimated blood loss, transfusion requirement, pathologic diagnosis, and complication rate were similar between groups. Patients who underwent LDPS tended to have larger masses and lower pancreatic fistula rates, but these differences were not significant. White blood cell (WBC) counts were significantly higher in the LDPS group than in the LSPDP group on postoperative days 1 and 7. To avoid splenectomy-associated complications, preservation of the spleen and especially the splenic vessels are preferred. This procedure can be performed safely and feasibly. Lower postoperative WBC counts may imply better splenic function.

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Laparoscopic versus open distal pancreatectomy: a systematic review of comparative studies

Cited by 136 publications

References 31 publications

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Spleen-Preserving Versus Spleen-Sacrificing Distal Pancreatectomy in Laparoscopy and Open Method-Perioperative Outcome Analysis—14 Years Experience

Laparoscopic distal pancreatectomy in Italy: a systematic review and meta-analysis

Comparison of Laparoscopic Distal Pancreatectomy with or without Splenic Preservation

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