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Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study.
- Source :
-
Journal of Zhejiang University. Science. B [J Zhejiang Univ Sci B] 2015 Jul; Vol. 16 (7), pp. 573-9. - Publication Year :
- 2015
-
Abstract
- Objective: To compare the peri-operative outcomes for laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for benign or premalignant pancreatic neoplasms in two institutions.<br />Methods: This prospective comparative study included 91 consecutive patients who underwent LDP (n=45) or ODP (n=46) from Jan. 2010 to Dec. 2012. Demographics, intra-operative characteristics, and post-operative outcomes were compared.<br />Results: The median operating time in the LDP group was (158.7±38.3) min compared with (92.2±24.1) min in the ODP group (P<0.001). Patients had lower blood loss in LDP than in the ODP ((122.6±61.1) ml vs. (203.1±84.8) ml, P<0.001). The rates of splenic conservation between the LDP and ODP groups were similar (53.3% vs. 47.8%, P=0.35). All spleen-preserving distal pancreatectomies were conducted with vessel preservation. LDP also demonstrated better post-operative outcomes. The time to oral intake and normal daily activities was faster in the LDP group than in the ODP group ((1.6±0.5) d vs. (3.2±0.7) d, P<0.01; (1.8±0.4) d vs. (2.1±0.6) d, P=0.02, respectively), and the post-operative length of hospital stay in LDP was shorter than that in ODP ((7.9±3.8) d vs. (11.9±5.8) d, P=0.006). No difference in tumor size ((4.7±3.2) cm vs. (4.5±1.8) cm, P=0.77) or overall pancreatic fistula rate (15.6% vs. 19.6%, P=0.62) was found between the groups, while the overall post-operative complication rate was lower in the LDP group (26.7% vs. 47.8%, P=0.04).<br />Conclusions: LDP is safe and effective for benign or premalignant pancreatic neoplasms, featuring lower blood loss and substantially faster recovery.
- Subjects :
- Activities of Daily Living
China
Female
Humans
Male
Middle Aged
Organ Sparing Treatments statistics & numerical data
Pancreatic Neoplasms diagnosis
Prevalence
Recovery of Function
Retrospective Studies
Risk Factors
Spleen surgery
Treatment Outcome
Laparoscopy statistics & numerical data
Operative Time
Pancreatectomy statistics & numerical data
Pancreatic Neoplasms epidemiology
Pancreatic Neoplasms surgery
Postoperative Complications epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1862-1783
- Volume :
- 16
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- Journal of Zhejiang University. Science. B
- Publication Type :
- Academic Journal
- Accession number :
- 26160714
- Full Text :
- https://doi.org/10.1631/jzus.B1400257