title: Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications.
abstract: BACKGROUND
  Laparoscopic distal pancreatectomy (LDP) is increasingly performed for lesions of the body and tail of the pancreas. The aim of this study was to investigate short-term outcomes after LDP compared to open distal pancreatectomy (ODP) at a single, high-volume institution.
  
  
  METHODS
  We reviewed records of patients who underwent distal pancreatectomy (DP) and compared perioperative data between LDP and ODP. Continuous variables were compared using Student's t or Wilcoxon rank-sum tests. Categorical variables were compared using chi-square or Fisher's exact test.
  
  
  RESULTS
  A total of 360 patients underwent DP. Beginning in 2001, 95 were attempted, and 71 were completed laparoscopically with a 25.3% conversion rate. Compared to ODP, LDP had similar rates of splenic preservation, pancreatic fistula, and mortality. LDP had lower blood loss (150 vs. 900 mL, p < 0.01), smaller tumor size (2.5 vs. 3.6 cm, p < 0.01), and shorter length of resected pancreas (7.7 vs. 10.0 cm, p < 0.01). LDP had fewer complications (28.2% vs. 43.8%, p = 0.02) as well as shorter hospital stays (5 vs. 6 days, p < 0.01).
  
  
  CONCLUSIONS
  LDP can be performed safely and effectively in patients with benign or low-grade malignant neoplasms of the distal pancreas. When feasible in selected patients, LDP offers fewer complications and shorter hospital stays.
authors.affiliation: Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: DiNorcia
authors.forename: Beth A
authors.initials: BA
authors.lastname: Schrope
authors.forename: Minna K
authors.initials: MK
authors.lastname: Lee
authors.forename: Patrick L
authors.initials: PL
authors.lastname: Reavey
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Rosen
authors.forename: James A
authors.initials: JA
authors.lastname: Lee
authors.forename: John A
authors.initials: JA
authors.lastname: Chabot
authors.forename: John D
authors.initials: JD
authors.lastname: Allendorf
mesh_terms: D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007813:Laparotomy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000601:surgery; D013156:Splenectomy