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The Indications for Laparoscopic Pancreatectomy
- Source :
- Deutsches Ärzteblatt international.
- Publication Year :
- 2017
- Publisher :
- Deutscher Arzte-Verlag GmbH, 2017.
-
Abstract
- Background Laparoscopic pancreatectomy is not yet established as a routine procedure everywhere in Germany or in other countries. Few data are available on its short- and long-term outcomes. Methods From 2008 onward, a working group initiated by 10 centers and currently comprising 34 centers has gathered data on all cases of laparoscopic pancreatectomy. Procedures in which laparoscopy was converted to open surgery are also included. Results The registry now contains 550 data sets representing 267 cases of benign disease, 244 malignancies, and 39 borderline tumors. The most common procedure was laparoscopic left pancreatectomy, followed by resection of the head of the pancreas and tumor enucleation. The most common intraoperative complication was hemorrhage, with a frequency of 3%. The rate of conversion to open surgery was 35%; if minilaparotomies are excluded, the conversion rate was only 16%. 39% of patients developed a pancreatic fistula after surgery (usually grade A or B, with 1.5% grade C) and 3% underwent reoperation because of postoperative hemorrhage. The procedure-related mortality was 1.3%. 91% of the patients reported only very mild postoperative pain. 6.7% newly developed diabetes mellitus after the procedure. Conclusion The patient cohort in the registry consists of persons who were selected to undergo laparoscopic pancreatectomy by the participating hospital teams, and the data are thus inherently affected by selection bias. The operative procedures that they underwent reflect the current practice of laparoscopic pancreatectomy in Germany. The complication rates are similar to those of open surgery. Selection bias can be avoided only by a randomized trial.
- Subjects :
- medicine.medical_specialty
Intraoperative Complication
medicine.diagnostic_test
business.industry
Retrospective cohort study
General Medicine
030230 surgery
medicine.disease
Surgery
law.invention
03 medical and health sciences
0302 clinical medicine
Randomized controlled trial
law
Pancreatic fistula
030220 oncology & carcinogenesis
Diabetes mellitus
Cohort
medicine
business
Complication
Laparoscopy
Subjects
Details
- ISSN :
- 18660452
- Database :
- OpenAIRE
- Journal :
- Deutsches Ă„rzteblatt international
- Accession number :
- edsair.doi...........905e305b1bb14f85b02059f276d6f208