Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications.
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.
DiNorcia
Joseph
J
Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
Schrope
Beth A
BA
Lee
Minna K
MK
Reavey
Patrick L
PL
Rosen
Sarah J
SJ
Lee
James A
JA
Chabot
John A
JA
Allendorf
John D
JD
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