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Conversion to open laparotomy during laparoscopic distal pancreatectomy: lessons from a single-center experience in 70 consecutive patients
- Source :
- Surgery today. 51(1)
- Publication Year :
- 2020
-
Abstract
- The purpose of this study was to determine the factors influencing conversion from laparoscopic distal pancreatectomy (LDP) to open surgery, and the effect of such conversion on the outcome. This retrospective single-center study included 70 consecutive patients undergoing LDP. The primary endpoint was the rate of conversion to open surgery during LDP. The secondary endpoints were determining the reasons for conversion to open surgery, with detailed analyses of these cases and a comparison of the surgical outcome with and without conversion. Seven patients (10%) required conversion to open surgery during LDP. Pancreatic ductal adenocarcinoma (PDAC) was identified as a risk factor for conversion (p = 0.010). The reasons for conversion included technical difficulty (two bleeding, one severe adhesion) and pancreatic stump-related issues (two margin-positive, two stapling failures). Although the overall morbidity rate (29 vs. 11%, p = 0.48) and the rate of clinically relevant postoperative pancreatic fistula (14 vs. 5%, p = 0.82) were no different for the patients with or without open conversion, the postoperative hospital stay was significantly longer in the former (median 15 vs. 10 days, p = 0.03). Careful preoperative assessment is required when planning LDP for PDAC. Although conversion to open surgery does not result in failure of LDP, efforts to reduce the duration of postoperative hospital stay and the occurrence of complications are desirable to improve the outcome of LDP.
- Subjects :
- Adult
Male
medicine.medical_specialty
Adolescent
medicine.medical_treatment
Adhesion (medicine)
Single Center
Pancreatic Fistula
Young Adult
Pancreatectomy
Postoperative Complications
Surgical oncology
Laparotomy
medicine
Clinical endpoint
Humans
Risk factor
Aged
Aged, 80 and over
business.industry
Mortality rate
General Medicine
Length of Stay
Middle Aged
medicine.disease
Conversion to Open Surgery
Surgery
Pancreatic Neoplasms
Treatment Outcome
Pancreatic fistula
Female
Laparoscopy
business
Carcinoma, Pancreatic Ductal
Subjects
Details
- ISSN :
- 14362813
- Volume :
- 51
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Surgery today
- Accession number :
- edsair.doi.dedup.....2e11be695aa5b2844770c3f71761e87c