title: The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes.
abstract: BACKGROUND
  The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established.
  
  
  METHODS
  The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011.
  
  
  RESULTS
  One hundred forty-five patients underwent LDP; 625 underwent ODP. Compared with ODP, patients undergoing LDP were older (68 ± 10.1 vs 66 ± 10.5 years, P = .027), more likely treated in academic centers (70% vs 59%, P = .01), and had shorter hospital stays (6.8 ± 4.6 vs 8.9 ± 7.5 days, P < .001). Demographic data, lymph node count, 30-day unplanned readmission, and 30-day mortality were identical between groups. Multivariable regression identified a lower probability of prolonged length of stay with LDP (odds ratio .51, 95% confidence interval .327 to .785, P = .0023). There was no association between surgical approach and node count, readmission, or mortality.
  
  
  CONCLUSIONS
  LDP for DAC provides shorter postoperative lengths of stay and rates of readmission and 30-day mortality similar to OPD without compromising perioperative oncologic outcomes.
authors.affiliation: Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Sharpe
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Talamonti
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: Edward
authors.initials: E
authors.lastname: Wang
authors.affiliation: Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bentrem
authors.affiliation: Department of Surgery, Pritzker School of Medicine, University of Chicago, Chicago, IL, USA.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Roggin
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prinz
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: Robert D W
authors.initials: RD
authors.lastname: Marsh
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Stocker
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA.
authors.forename: David J
authors.initials: DJ
authors.lastname: Winchester
authors.affiliation: Department of Surgery, NorthShore University HealthSystems, Evanston, IL, USA. Electronic address: MBaker3@northshore.org.
authors.forename: Marshall S
authors.initials: MS
authors.lastname: Baker
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007087:Illinois / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay / Q000639:trends*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011184:Postoperative Period; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome
keywords: Adenocarcinoma; Distal; Laparoscopy; Open; Pancreatectomy