Top

Langenbeck's Archives of Surgery

Published in:

01-12-2013 | Original Article

Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study

Authors: Sven-Petter Haugvik, Bård Ingvald Røsok, Anne Waage, Øystein Mathisen, Bjørn Edwin

Published in: Langenbeck's Archives of Surgery | Issue 8/2013

Abstract

Purpose

Laparoscopic distal pancreatectomy is becoming increasingly established at specialized surgical institutions worldwide. The purpose of this study was to compare single-incision laparoscopic distal pancreatectomy (panLESS) with conventional laparoscopic distal pancreatectomy (panLAP) to assess feasibility and 30-day morbidity.

Methods

Eight consecutive patients who underwent panLESS were matched with patients who underwent panLAP in the same time period. Matching criteria were age, body mass index, and American Society of Anesthesiologists score. Feasibility was based on tumor size, operative time, intraoperative bleeding, resection status, and hospital stay. Thirty-day morbidity was defined by the revised Accordion Classification system and the International Study Group on Pancreatic Fistula definition.

Results

Over a 19-month period, 8 and 16 patients were identified for panLESS and panLAP, respectively. There were no significant differences in tumor size, operative time, intraoperative bleeding, resection status, and hospital stay between the two groups. Surgical complications developed in four panLESS patients and five panLAP patients, and out of which, two patients from each group developed a postoperative pancreatic fistula (grade B).

Conclusions

This study indicates that panLESS is comparable to panLAP in terms of feasibility. More experience is needed to define what role single-incision distal pancreatectomy should have in minimal invasive pancreatic surgery.

Fernandez-Cruz L, Cosa R, Blanco L et al (2007) Curative laparoscopic resection for pancreatic neoplasms: a critical analysis from a single institution. J Gastrointest Surg 11(12):1607–1621PubMedCrossRef

Kooby DA, Gillespie T, Bentrem D et al (2008) Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg 248(3):438–446PubMed

Mabrut JY, Fernandez-Cruz L, Azagra JS et al (2005) Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery 137(6):597–605PubMedCrossRef

Eom BW, Jang JY, Lee SE et al (2008) Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc 22(5):1334–1338PubMedCrossRef

Rosok BI, Marangos IP, Kazaryan AM et al (2010) Single-centre experience of laparoscopic pancreatic surgery. Br J Surg 97(6):902–909PubMedCrossRef

Kneuertz PJ, Patel SH, Chu CK et al (2012) Laparoscopic distal pancreatectomy: trends and lessons learned through an 11-year experience. J Am Coll Surg 215(2):167–176PubMedCrossRef

Abu HM, Hamdan M, Di FF et al (2012) Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study. Surg Endosc 26(6):1670–1674CrossRef

Fox AM, Pitzul K, Bhojani F et al (2012) Comparison of outcomes and costs between laparoscopic distal pancreatectomy and open resection at a single center. Surg Endosc 26(5):1220–1230PubMedCrossRef

Butturini G, Inama M, Malleo G et al (2012) Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: a retrospective analysis. J Surg Oncol 105(4):387–392PubMedCrossRef

10.

Chang SK, Lomanto D, Mayasari M (2012) Single-port laparoscopic spleen preserving distal pancreatectomy. Minim Invasive Surg 2012:197429PubMed

11.

Kuroki T, Adachi T, Okamoto T et al (2011) Single-incision laparoscopic distal pancreatectomy. Hepatogastroenterology 58(107–108):1022–1024PubMed

12.

Matthes K, Thakkar SJ, Lee SH et al (2011) Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation. Surg Endosc 25(10):3191–3197PubMedCrossRef

13.

Matthes K, Yusuf TE, Willingham FF et al (2007) Feasibility of endoscopic transgastric distal pancreatectomy in a porcine animal model. Gastrointest Endosc 66(4):762–766PubMedCrossRef

14.

Horiguchi A, Uyama I, Ito M et al (2011) Robot-assisted laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Sci 18(4):488–492PubMedCrossRef

15.

Kang CM, Kim DH, Lee WJ et al (2011) Conventional laparoscopic and robot-assisted spleen-preserving pancreatectomy: does da Vinci have clinical advantages? Surg Endosc 25(6):2004–2009PubMedCrossRef

16.

Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc 24(7):1646–1657PubMedCrossRef

17.

Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic middle pancreatectomy. J Laparoendosc Adv Surg Tech A 20(2):135–139PubMedCrossRef

18.

Porembka MR, Hall BL, Hirbe M et al (2010) Quantitative weighting of postoperative complications based on the accordion severity grading system: demonstration of potential impact using the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 210(3):286–298PubMedCrossRef

19.

Bassi C, Dervenis C, Butturini G et al (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138(1):8–13PubMedCrossRef

20.

Edwin B, Mala T, Mathisen O et al (2004) Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg Endosc 18(3):407–411PubMedCrossRef

21.

Pfluke JM, Parker M, Stauffer JA et al (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212(1):113–118PubMedCrossRef

22.

Giulianotti PC, Kuechle J, Salehi P et al (2009) Robotic-assisted laparoscopic distal pancreatectomy of a redo case combined with autologous islet transplantation for chronic pancreatitis. Pancreas 38(1):105–107PubMedCrossRef

23.

Marangos IP, Buanes T, Rosok BI et al (2012) Laparoscopic resection of exocrine carcinoma in central and distal pancreas results in a high rate of radical resections and long postoperative survival. Surgery 151(5):717–723PubMedCrossRef

24.

Kooby DA, Hawkins WG, Schmidt CM et al (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(5):779–7PubMedCrossRef

Title: Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study
Authors: Sven-Petter Haugvik
Bård Ingvald Røsok
Anne Waage
Øystein Mathisen
Bjørn Edwin
Publication date: 01-12-2013
Publisher: Springer Berlin Heidelberg
Published in: Langenbeck's Archives of Surgery / Issue 8/2013
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-013-1133-y

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 8/2013

Sorafenib treatment is save and may affect survival of recurrent hepatocellular carcinoma after liver transplantation

ENERgized vessel sealing systems versus CONventional hemostasis techniques in thyroid surgery—the ENERCON systematic review and network meta-analysis

Pancreatoduodenectomy—current status of surgical and perioperative techniques in Germany

Evaluation of short-term and long-term results after laparoscopic antireflux surgery: esophageal manometry and 24-h pH monitoring versus quality of life index

Surgical strategy for T2 and T3 gallbladder cancer: is extrahepatic bile duct resection always necessary?

IPMN: surgical treatment