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| Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study |
| Jia-fei Yan, Tian-tao Kuang, Da-yong Ji, Xiao-wu Xu, Dan-song Wang, Ren-chao Zhang, Wei-wei Jin, Yi-ping Mou, Wen-hui Lou |
| Department of General Surgery, Institute of Micro-Invasive Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China; Department of General Surgery, Zhongshan Hospital, Shanghai Medical College, Fudan University, Shanghai 200032, China |
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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. 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. 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). Conclusions: LDP is safe and effective for benign or premalignant pancreatic neoplasms, featuring lower blood loss and substantially faster recovery.
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Received: 25 September 2014
Published: 03 July 2015
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Cite this article:
Jia-fei Yan, Tian-tao Kuang, Da-yong Ji, Xiao-wu Xu, Dan-song Wang, Ren-chao Zhang, Wei-wei Jin, Yi-ping Mou, Wen-hui Lou. Laparoscopic versus open distal pancreatectomy for benign or premalignant pancreatic neoplasms: a two-center comparative study. Journal of Zhejiang University-SCIENCE B (Biomedicine & Biotechnology), 2015, 16(7): 573-579.
URL:
http://www.zjujournals.com/xueshu/zjus-b/10.1631/jzus.B1400257 OR http://www.zjujournals.com/xueshu/zjus-b/Y2015/V16/I7/573
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