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01-07-2018

Impact of laparoscopy in patients aged over 70 years requiring distal pancreatectomy: a French multicentric comparative study

Authors: Regis Souche, David Fuks, Julie Perinel, Astrid Herrero, Françoise Guillon, Isabelle Pirlet, Thierry Perniceni, Frederic Borie, Antonio Sa Cunha, Brice Gayet, Jean-Michel Fabre

Published in: Surgical Endoscopy | Issue 7/2018

Abstract

Background

Few data are available concerning short-term results of minimally invasive surgery in patients > 70 years old requiring distal pancreatectomy. The aim of this study was to compare short-term results after laparoscopic (LDP) versus open distal pancreatectomy (ODP) in this subgroup of patients.

Methods

All patients > 70 years who underwent distal pancreatectomy in 3 expert centers between 1995 and 2017 were included and data were retrospectively analyzed. Demographic, intraoperative data and postoperative outcomes in LDP and ODP groups were compared.

Results

A distal pancreatectomy was performed in 109 elderly patients; LDP group included 53 patients while ODP group included 56. There were 55 (50.5%) males and 54 (49.5%) women with a median age of 75 years (range 70–87). Fifty (45.9%) patients were 70–74, 40 (36.7%) patients were 75–79, and 19 (17.4%) patients were over 80 years. Nine (8.2%) patients required conversion to open surgery. The median operative time was not different between LDP and ODP (204 vs. 220 min, p = 0.62). The intraoperative blood loss was significantly lower in the LDP group (238 ± 312 vs. 425 ± 582 ml, p = 0.009) with no difference regarding the intraoperative transfusion rate. 90-day mortality (0 vs. 5%, p = 0.42), overall complication (45.4 vs. 51.8%, p = 0.53), major complication (18.2 vs. 12.5%, p = 0.43), grade B/C pancreatic fistula (6.8 vs. 7.1%, p = 0.71), were comparable in the 2 groups. Only postoperative confusion rate was significantly lower in the LDP group (4.5 vs. 25%, p = 0.01). Median length of stay was significantly lower in the LDP group (14 ± 10 vs. 16 ± 11 days, p = 0.04). R0 resection was performed in 94% of LDP patients and 89% in ODP patients without significant difference (p = 0.73).

Conclusions

The laparoscopic approach seems to reduce blood loss, postoperative confusion, and length of stay in elderly patients requiring distal pancreatectomy.

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Title: Impact of laparoscopy in patients aged over 70 years requiring distal pancreatectomy: a French multicentric comparative study
Authors: Regis Souche
David Fuks
Julie Perinel
Astrid Herrero
Françoise Guillon
Isabelle Pirlet
Thierry Perniceni
Frederic Borie
Antonio Sa Cunha
Brice Gayet
Jean-Michel Fabre
Publication date: 01-07-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 7/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6033-3

At a glance: The STEP trials

Springer Medicine

Impact of laparoscopy in patients aged over 70 years requiring distal pancreatectomy: a French multicentric comparative study

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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