Back to Search
Start Over
Role of laparoscopic enucleation in the treatment of pancreatic lesions: case series and case-matched analysis
- Source :
- Surgical Endoscopy. 31:2310-2316
- Publication Year :
- 2016
- Publisher :
- Springer Science and Business Media LLC, 2016.
-
Abstract
- Previous studies report successful application of laparoscopic pancreatic enucleation (LPE). However, the evidence is limited to small series. This study aimed to evaluate the indications, technique and outcome of LPE at a tertiary care institution. Between February 1998 and April 2016, 45 consecutive LPEs were performed at Oslo University Hospital—Rikshospitalet. Twenty-four (53.3 %) patients subjected to right-sided LPE (RLPE) were compared with 21 (46.7 %) patients who had undergone left-sided LPE (LLPE). A case-matched analysis (1:2) was performed to compare the outcomes following LLPE and laparoscopic distal pancreatectomy (LDP). Patient demographics, BMI, ASA score and pathological characteristics were similar between the RLPE and LLPE groups. Operative time was slightly longer for RLPE [123 (53–320) vs 102 (50–373) min, P = 0.09]. The rates of severe morbidity (≥Accordion grade III) and clinically relevant pancreatic fistula (grades B/C) were comparable, although with a trend for higher rate of complications following LLPE (16.7 vs 33.3 %; P = 0.19 and 20.8 vs 33.3 %, P = 0.34, respectively). The hospital stay was similar between RLPE and LLPE [5 (2–80) vs 7 (2–52), P = 0.49]. A case-matched analysis demonstrated shorter operating time [145 (90–350) vs 103 (50–233) min, P = 0.02], but higher readmission rate following LLPE (25 vs 3.1 %, P = 0.037). LLPE seems to be associated with a higher risk of postoperative morbidity and readmission rates than LDP. RLPE is a feasible, safe approach and a reasonable alternative to pancreatoduodenectomy in selected patients with pancreatic lesions.
- Subjects :
- Adult
Male
medicine.medical_specialty
medicine.medical_treatment
Operative Time
Enucleation
030230 surgery
Pancreatic Fistula
03 medical and health sciences
Pancreatectomy
0302 clinical medicine
Internal medicine
medicine
Humans
Laparoscopy
Pathological
Aged
medicine.diagnostic_test
business.industry
Length of Stay
Middle Aged
Hepatology
medicine.disease
Surgery
Pancreatic Neoplasms
Pancreatic fistula
030220 oncology & carcinogenesis
Operative time
Female
business
Organ Sparing Treatments
Abdominal surgery
Subjects
Details
- ISSN :
- 14322218 and 09302794
- Volume :
- 31
- Database :
- OpenAIRE
- Journal :
- Surgical Endoscopy
- Accession number :
- edsair.doi.dedup.....6058536043339536520a7f9dfb507310