title: Laparoscopic resection of exocrine carcinoma in central and distal pancreas results in a high rate of radical resections and long postoperative survival.
abstract: BACKGROUND
  The role of laparoscopic resection in patients with pancreatic cancer remains to be clarified, because previous reports have not clearly defined oncologic outcomes. The objective of the present study was to investigate this question with the rate of R0 resection and long-term survival as endpoints.
  
  
  METHODS
  This retrospective observational study included prospectively collected data from 40 patients operated laparoscopically with curative intent for exocrine pancreatic malignancies identified among 250 consecutive patients undergoing laparoscopic pancreatic operations since 1997. All 40 patients had histologically verified exocrine pancreatic carcinoma.
  
  
  RESULTS
  Ten patients (25%) with typical ductal adenocarcinoma of the pancreas were deemed nonresectable by laparoscopic staging. Laparoscopic distal pancreatectomy was performed in 29 patients; 8 resections were combined with resections of adjacent organs and 1 removal of a malignant intraductal papillary mucinous neoplasm what appeared to be ectopic pancreatic tissue. In 1 patient, the resection was completed by hand-assisted technique, and 1 procedure was converted to open resection. Postoperative morbidity was 23% (n = 7). The median hospital stay was 5 days (range, 1-30). The rate of R0 resections was 93%. Postoperative 3-year survivals rates were 36% for the entire cohort (n = 30) and 30% in typical ductal adenocarcinoma (n = 21).
  
  
  CONCLUSIONS
  Laparoscopic distal pancreatectomy for exocrine pancreatic carcinoma is comparable with outcomes after open surgery and supports the concept that laparoscopic distal pancreatectomy is a safe, oncologic procedure.
authors.affiliation: Interventional Centre, Oslo University Hospital, Rikshospitalet, Oslo, Norway. irinapavlik25@gmail.com
authors.forename: Irina Pavlik
authors.initials: IP
authors.lastname: Marangos
authors.forename: Trond
authors.initials: T
authors.lastname: Buanes
authors.forename: Bård I
authors.initials: BI
authors.lastname: Røsok
authors.forename: Airazat M
authors.initials: AM
authors.lastname: Kazaryan
authors.forename: Arne R
authors.initials: AR
authors.lastname: Rosseland
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Grzyb
authors.forename: Olaug
authors.initials: O
authors.lastname: Villanger
authors.forename: Øystein
authors.initials: Ø
authors.lastname: Mathisen
authors.forename: Ivar P
authors.initials: IP
authors.lastname: Gladhaug
authors.forename: Bjørn
authors.initials: B
authors.lastname: Edwin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000401:mortality / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D046790:Pancreas, Exocrine / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome