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World Journal of Surgery

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01-06-2016 | Original Scientific Report

Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma

Authors: John A. Stauffer, Alessandro Coppola, Kabir Mody, Horacio J. Asbun

Published in: World Journal of Surgery | Issue 6/2016

Abstract

Background

Laparoscopic distal pancreatectomy (LDP) has been shown to have short-term benefits over open distal pancreatectomy (ODP). Its application for pancreatic ductal adenocarcinoma (PDAC) remains controversial.

Methods

From 1995 to 2014, 72 patients underwent distal pancreatectomy for PDAC at a single institution and were included in the study. Postoperative and long-term outcomes of patients undergoing LDP (n = 44) or ODP (n = 28) were compared.

Results

LDP was associated with less blood loss (332 vs. 874 mL, p = 0.0012) and lower transfusion rates than ODP (18.2 vs. 50 %, p = 0.0495). Operative time was similar (254 vs. 266 min) for LDP and ODP; five patients (11.4 %) required conversion to ODP. Pancreatic fistulas (13.6 vs. 7.1 %) and major complications (13.6 vs. 25 %), were similar between LDP and ODP, respectively. Length of hospital stay (5.1 vs. 9.4 days, p = 0.0001) and time to initiate adjuvant therapy (69.4 vs. 95.6 days, p = 0.0441) was shorter for LDP than ODP. Tumor characteristics were similar but LDP was associated with more resected lymph nodes than ODP (25.9 vs. 12.7, p = 0.0001). One-, three-, and five-year survival rates were similar between LDP (69, 41, and 41 %, respectively) and ODP (78, 44, and 32 %, respectively).

Conclusion

LDP is associated with less blood loss and need for blood transfusion, shorter hospital stay, and faster time to initiate adjuvant therapy than ODP for patients with PDAC. Postoperative outcomes and long-term survival are similar between the two groups. LDP appears to be safe in the treatment of patients with PDAC.

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Title: Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma
Authors: John A. Stauffer
Alessandro Coppola
Kabir Mody
Horacio J. Asbun
Publication date: 01-06-2016
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 6/2016
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-016-3412-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma

Abstract

Background

Methods

Results

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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