Laparoscopic versus open distal pancreatectomy: a single-institution comparative study.
BACKGROUND
This study was designed to compare clinical outcomes for laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) performed at a single institution.


METHODS
This retrospective study included 43 patients who underwent distal pancreatectomy between 2009 and 2013. The patients were divided into two groups based on the surgical approach: the laparoscopic surgery group (n=20) and the open surgery group (n=23). All clinical data were analyzed retrospectively.


RESULTS
There were no significant differences in operation time, rate of intraoperative transfusions, complications, or mortality between the two groups. The intraoperative blood loss (210±84.4 mL vs. 420±91.1 mL), first flatus time (1.5±1 d vs. 4±2.5 d), diet start time (2±0.7 d vs. 6±1.8 d), and postoperative hospital stay (8±3.5 d vs. 14±5.5 d) were significantly less in the LDP group than in the ODP group. All patients had negative surgical margins at final pathology. There were no significant differences in the number of lymph nodes harvested (10±2.1 vs. 11±3.2) between the two groups.


CONCLUSIONS
LDP is a feasible and safe surgical approach as well as ODP, but has the advantages of an earlier return to normal bowel movements, normal diet, and shorter hospital stays than ODP.
Yue
Y
Zhang
Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China. tomuer@126.com.
Xue-Min
XM
Chen
Dong-Lin
DL
Sun
D002288:Adenocarcinoma, Mucinous / Q000473:pathology / Q000601:surgery; D000328:Adult; D016063:Blood Loss, Surgical; D001803:Blood Transfusion; D021441:Carcinoma, Pancreatic Ductal / Q000473:pathology / Q000601:surgery; D002291:Carcinoma, Papillary / Q000473:pathology / Q000601:surgery; D018284:Cystadenocarcinoma, Serous / Q000473:pathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D010180:Pancreatectomy; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011379:Prognosis; D012189:Retrospective Studies