Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: A two-center comparative study

Yan, Jing; Kuang, Tiantao; Ji, Da-yong; Xu, Xiaorong; Wang, Dansong; Zhang, Ren-chao; Jin, Weiwei; Mou, Yiping; Lou, Wenhui

doi:10.1631/jzus.b1400257

Cited by 17 publications

(9 citation statements)

References 28 publications

(31 reference statements)

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“…The evolution of laparoscopic techniques represents one of the great leaps in the field of surgery during the past decades. It has been reported that the LDP is associated with a reduction in postoperative morbidity and shorter hospital stays in comparison with the open approach (Kooby et al, 2008;Baker et al, 2009;Briggs et al, 2009;Yan et al, 2015). In this study, patients in the LDP group experienced a similar overall morbidity as those in the ODP group.…”

Section: Discussionsupporting

confidence: 57%

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Zhang

Wang

et al. 2017

J. Zhejiang Univ. Sci. B

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Section: Discussionsupporting

confidence: 57%

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Zhang

Wang

et al. 2017

J. Zhejiang Univ. Sci. B

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“…EU, first reported in 1898 by Ernesto Tricomi (Howard and Hess, 2002), has been widely accepted as an alternative procedure for benign and low-grade malignant pancreatic tumors including endocrine tumors (Ramage et al, 2005;Norton, 2006;Crippa et al, 2007;Falconi et al, 2010;Hackert et al, 2011;Zhang et al, 2013), SCAs, MCNs, SPTs, branch-duct IPMNs, pseudocysts, and so forth (Talamini et al, 1998;Kiely et al, 2003;Madan et al, 2004;Papavramidis and Papavramidis, 2005;Crippa et al, 2007;Ge et al, 2010;Hackert et al, 2011;Turrini et al, 2011;Zhang et al, 2013). EU has proved to be a procedure characterized by less operation time and blood loss, faster recovery, and preserving more of the pancreas parenchyma, compared with standard procedures (Casadei et al, 2010;Falconi et al, 2010;Hackert et al, 2011;Yan et al, 2015). Yet there are some problems for the application of EUs, including PF afterwards and indications and contraindications for EUs.…”

Section: Discussionmentioning

confidence: 99%

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Cai

et al. 2017

J. Zhejiang Univ. Sci. B

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Abstract:Objective: The aim of this study was to evaluate the safety and efficiency of enucleation (EU) for proximal pancreatic non-invasive neoplasms. Methods: Patients with solitary non-invasive neoplasms in the proximal pancreas from January 1998 to April 2014 at the Second Affiliated Hospital of Zhejiang University, Hangzhou, China were included. Different operations and outcomes were analyzed. Results: A total of 123 patients were enrolled. Forty patients (32.5%) underwent EU including 18 patients who had tumors close to the main pancreatic duct (MPD). Sixty-one patients (49.6%) had pancreaticoduodenectomy (PD) performed and 22 (17.9%) underwent central pancreatectomy (CP). Pathological outcomes included neuroendocrine tumors, cystic lesions, and solid pseudopapillary tumors. Operation time, intra-operative blood loss, and duration of hospital stay were significantly reduced in the EU group. PD was associated with the greatest complication rate (55.7%), followed by EU (50%) and CP (40.9%), though the pancreatic fistula rate after EU was the highest (50%), especially in patients with tumors larger than 3 cm and tumors close to the MPD. EU had advantages in the preservation of pancreatic parenchyma and endocrine and exocrine function. Conclusions: EU can be carried out safely and effectively for tumors in the proximal pancreas with improved outcomes compared with standard resections, even if the tumor is larger than 3 cm and close to the MPD.

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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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Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: A two-center comparative study

Cited by 17 publications

References 28 publications

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Enucleation of non-invasive tumors in the proximal pancreas: indications and outcomes compared with standard resections

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

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