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Surgical Endoscopy

Published in:

01-07-2016

Laparoscopic versus open enucleation for pancreatic neoplasms: clinical outcomes and pancreatic function analysis

Authors: Ren-Chao Zhang, Yu-Cheng Zhou, Yi-Ping Mou, Chao-Jie Huang, Wei-Wei Jin, Jia-Fei Yan, Yong-Xiang Wang, Yi Liao

Published in: Surgical Endoscopy | Issue 7/2016

Abstract

Background

The studies comparing laparoscopic enucleation (LE) with open enucleation (OE) are limited. This study aimed to compare perioperative outcomes of patients undergoing LE and OE and to assess the pancreatic function after LE.

Methods

Between February 2001 and July 2014, patients who underwent enucleation were reviewed. Patients were divided into two groups as LE and OE. Data considered for comparison analysis were patient demographics, intraoperative variables, morbidity, postoperative hospital stay, mortality, pathologic findings, and long-term follow-up (including pancreatic function).

Results

Thirty-seven patients (15 LE and 22 OE) were included in the final analysis. Baseline characteristics were similar in the two groups. LE group showed significantly shorter operating time (118.2 ± 33.1 vs. 155.2 ± 44.3 min, p = 0.009), lower estimated blood loss (80.0 ± 71.2 vs. 195.5 ± 103.4 ml, p = 0.001), shorter first flatus time (1.8 ± 1.0 vs. 3.4 ± 1.8 days, p = 0.004), shorter diet start time (2.4 ± 1.0 vs. 4.4 ± 2.0 days, p = 0.001), shorter postoperative hospital stay (7.9 ± 3.4 vs. 11.2 ± 5.7 days, p = 0.046). Postoperative outcomes, including morbidity (40.0 vs. 45.5 %, p = 1.000), grade B/C pancreatic fistula rates (20.0 vs. 13.6 %, p = 0.874), and mortality, were similar in the two groups. The median follow-up period was 47 months (range 7–163 months). No local recurrence or distant metastasis was detected in either group. Only one patient (4.8 %) underwent OE developed new-onset diabetes, in comparison with none in the LE group. One patient (7.1 %) had weight loss and received pancreatic enzyme supplementation in the LE group, in comparison with two patients (9.5 %) in the OE group.

Conclusions

LE is a safe and feasible technique for the benign or low malignant-potential pancreatic neoplasms. Compared to OE, LE had shorter operating time, lower estimated blood loss, and faster recovery. LE could preserve the pancreatic function as the OE.

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Title: Laparoscopic versus open enucleation for pancreatic neoplasms: clinical outcomes and pancreatic function analysis
Authors: Ren-Chao Zhang
Yu-Cheng Zhou
Yi-Ping Mou
Chao-Jie Huang
Wei-Wei Jin
Jia-Fei Yan
Yong-Xiang Wang
Yi Liao
Publication date: 01-07-2016
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4538-6

At a glance: The STEP trials

Springer Medicine

Laparoscopic versus open enucleation for pancreatic neoplasms: clinical outcomes and pancreatic function analysis

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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