Systematic Review and Meta-Analysis of Case-Matched Studies Comparing Open and Laparoscopic Distal Pancreatectomy

Pericleous, Stephanos; Middleton, Nicos; McKay, Siobhan C.; Bowers, Kaye; Hutchins, Robert

doi:10.1097/mpa.0b013e31824f3669

Cited by 106 publications

(81 citation statements)

References 15 publications

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“…It is noteworthy that there is a recent trend toward an increased size of the excised lesions (4.0 ± 2.8 cm vs. 3.3 ± 1.5 cm) noted in the literature. [20] Consistent with previous studies, [14,15] our operative time for LDP was longer than for ODP (median 195.5 vs. 112.5 min). Shin et al [22] reported a median operative time of 195 min for LDP, whereas Braga et al [28] reported a median duration of surgery of 239 min for LDP, significantly higher than that for ODP (213 min), but their series included a high rate (30%) of adenocarcinomas.…”

Section: Discussionsupporting

confidence: 80%

“…[5] More recently, several studies and meta-analyses have shown that LDP is a safe procedure, with improved outcomes and reduced hospital stays. [13][14][15][16] Cao et al [12] in their population-based retrospective cohort study reported a reduction of 1.22 days in LoS associated with minimally invasive surgery, with no differences in the perioperative mortality and total hospital costs. Furthermore, lower rates of infectious complications (30.1% vs. 39%) and bleeding complications (13.1% vs. 20.6%) were reported in LDP vs. ODP.…”

Section: Discussionmentioning

confidence: 99%

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Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

Basso¹,

Maffeis²,

Lumachi³

et al. 2017

MIS

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Aim: Laparoscopic pancreatic surgery is a minimally invasive technique that has been widely applied only in the past decade. The purpose of this study was to evaluate its safety and assess whether laparoscopic distal pancreatectomy (LDP) is cost-effective compared with open distal pancreatectomy (ODP). Methods: The medical records of patients treated for leftsided pancreatic lesions were retrospectively analysed, and the analysis of costs for hospital stay, operative time, and equipment were analysed. Twelve patients underwent LDP, while 12 patients underwent ODP. Results: The two groups were homogeneous according to age, ASA score, BMI, and distribution of pathological findings. Both the size of the specimen (5.33 ± 3.2 vs. 5.58 ± 2.57 cm) and the number of removed lymph nodes (10.5 ± 4.3 vs. 12.1 ± 3.1) did not differ. Although LDP required a longer operative time (197.5 ± 33.7 vs. 122.5 ± 35.4 min), intraoperative bleeding, postoperative pain intensity (measured by VAS scale) and hospital stay were significantly reduced. Conclusion: The mini-invasive approach offers several advantages compared with open surgery, including a significant reduction of blood loss and postoperative pain, and an earlier recovery. The global costs of laparoscopic surgery should be carefully re-evaluated, considering the saving that arises from these advantages. Key words:Mini-invasive, distal pancreatectomy, laparoscopy, cost ABSTRACTArticle history:

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Section: Discussionsupporting

confidence: 80%

Section: Discussionmentioning

confidence: 99%

Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

Basso¹,

Maffeis²,

Lumachi³

et al. 2017

MIS

View full text Add to dashboard Cite

show abstract

“…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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“…This is mainly due to the standardization of the technique. Based on the available data, laparoscopic distal pancreatectomy have adequate safety profiles, equivalent or better perioperative outcomes, and noninferior oncologic outcomes (4)(5)(6)14) .…”

Section: Discussionmentioning

confidence: 99%

First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado¹,

Surjan²,

Makdissi³

2013

Arq. Gastroenterol.

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-Context -Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. in the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. in the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives -We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and latin America. Methods -A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results -operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions -Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. laparoscopy.

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Systematic Review and Meta-Analysis of Case-Matched Studies Comparing Open and Laparoscopic Distal Pancreatectomy

Abstract: This study represents the strongest evidence (level 3a) to date that LDPs are a safe operation. However, there is still a need for randomized controlled trials to confirm this.

Cited by 106 publications

References 15 publications

Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

Mini-invasive distal pancreatectomy: a feasible and cost-effective technique

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

First Single-Port Laparoscopic Pancreatectomy in Brazil

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