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Published in: Journal of Hepato-Biliary-Pancreatic Sciences 1/2009

01-01-2009 | ORIGINAL ARTICLE

Clinical outcome of laparoscopic distal pancreatectomy

Authors: Yoshiharu Nakamura, Eiji Uchida, Takayuki Aimoto, Satoshi Matsumoto, Hiroshi Yoshida, Takashi Tajiri

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 1/2009

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Abstract

Background

Few studies have compared laparoscopic distal pancreatectomy (Lap-DP) and open distal pancreatectomy (open-DP). The aim of this study was to evaluate the clinical outcome of Lap-DP and compare it to that of open-DP.

Methods

A total of 37 patients who underwent distal pancreatectomy (Lap-DP, 21 patients; open-DP, 16 patients) between January 2000 and March 2007 were enrolled in this study. Prior to January 2004, open-DP was the standard procedure for patients with a lesion in the distal pancreas without invasive ductal cancer; thereafter, Lap-DP was also an approved procedure. All 16 open-DP procedures were performed prior to January 2004.

Results

The operating times for the Lap-DP and open-DP patients were 308.4 ± 124.6 and 281.5 ± 83.3 min, respectively, and these were not significantly different (P = 0.4635). Blood loss for the Lap-DP group (249.0 ± 239.8 ml) was significantly smaller than that for the open-DP group (714.1 ± 650.4 ml) (P = 0.0055), and none of the patients in the Lap-DP group received transfusions. The frequency of complications for the Lap-DP and open-DP groups was 0 and 18.8%, respectively, which is not significantly different (P = 0.0784). The average hospital stay for the Lap-DP group was significantly shorter than that for the open-DP group (10.0 ± 2.6 vs. 25.8 ± 8.8 days; P < 0.0001).

Conclusion

In pancreatic diseases, other than invasive ductal cancer, arising in the distal pancreas, Lap-DP might be a more feasible and safer than open-DP.
Literature
1.
go back to reference Gagner M, Pomp A, Herrera MF. Early experience with laparoscopic resections of islet cell tumors. Surgery. 1996;120:1051–4.PubMedCrossRef Gagner M, Pomp A, Herrera MF. Early experience with laparoscopic resections of islet cell tumors. Surgery. 1996;120:1051–4.PubMedCrossRef
2.
go back to reference Cuschieri A, Jakimowicz JJ, Spreeuwel J. Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. Ann Surg. 1996;223:280–5.PubMedCrossRef Cuschieri A, Jakimowicz JJ, Spreeuwel J. Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. Ann Surg. 1996;223:280–5.PubMedCrossRef
3.
go back to reference Patterson EJ, Gagner M, Salky B, Inabnet WB, Brower S, Edye M, et al. Laparoscopic pancreatic resection: single-institution experience of 19 patients. J Am Coll Surg. 2001;193:281–7.PubMedCrossRef Patterson EJ, Gagner M, Salky B, Inabnet WB, Brower S, Edye M, et al. Laparoscopic pancreatic resection: single-institution experience of 19 patients. J Am Coll Surg. 2001;193:281–7.PubMedCrossRef
4.
go back to reference Kano N, Kusanagi H, Yamada S, Kasama K, Ota A. Laparoscopic pancreatic surgery: its indications and techniques: from the viewpoint of limiting the indications. J Hepatobiliary Pancreat Surg. 2002;9:555–8.PubMedCrossRef Kano N, Kusanagi H, Yamada S, Kasama K, Ota A. Laparoscopic pancreatic surgery: its indications and techniques: from the viewpoint of limiting the indications. J Hepatobiliary Pancreat Surg. 2002;9:555–8.PubMedCrossRef
5.
6.
go back to reference Fernández-Cruz L, Sáenz A, Astudillo E, Martinez I, Hoyos S, Pantoja JP, et al. Outcome of laparoscopic pancreatic surgery: endocrine and nonendocrine tumors. World J Surg. 2002;26:1057–65.PubMedCrossRef Fernández-Cruz L, Sáenz A, Astudillo E, Martinez I, Hoyos S, Pantoja JP, et al. Outcome of laparoscopic pancreatic surgery: endocrine and nonendocrine tumors. World J Surg. 2002;26:1057–65.PubMedCrossRef
7.
go back to reference Fabre JM, Dulucq JL, Vacher C, Lemoine MC, Wintringer P, Nocca D, et al. Is laparoscopic left pancreatic resection justified? Surg Endosc. 2002;16:1358–61.PubMedCrossRef Fabre JM, Dulucq JL, Vacher C, Lemoine MC, Wintringer P, Nocca D, et al. Is laparoscopic left pancreatic resection justified? Surg Endosc. 2002;16:1358–61.PubMedCrossRef
8.
go back to reference Fernández-Cruz L, Sáenz A, Astudillo E, Pantoja JP, Uzcátegui E, Navarro S. Laparoscopic pancreatic surgery in patients with chronic pancreatitis. Surg Endosc. 2002;16:996–1003.PubMedCrossRef Fernández-Cruz L, Sáenz A, Astudillo E, Pantoja JP, Uzcátegui E, Navarro S. Laparoscopic pancreatic surgery in patients with chronic pancreatitis. Surg Endosc. 2002;16:996–1003.PubMedCrossRef
9.
go back to reference Ammori BJ. Applications of minimally invasive surgery in the management of inflammatory and neoplastic diseases of the pancreas. J Hepatobiliary Pancreat Surg. 2004;11:107–11.PubMedCrossRef Ammori BJ. Applications of minimally invasive surgery in the management of inflammatory and neoplastic diseases of the pancreas. J Hepatobiliary Pancreat Surg. 2004;11:107–11.PubMedCrossRef
10.
go back to reference Edwin B, Mala T, Mathisen Ø, Gladhaug I, Buanes T, Lunde OC, et al. Laparoscopic resection of the pancreas. A feasibility study of the short-term outcome. Surg Endosc. 2004;18:407–11.PubMedCrossRef Edwin B, Mala T, Mathisen Ø, Gladhaug I, Buanes T, Lunde OC, et al. Laparoscopic resection of the pancreas. A feasibility study of the short-term outcome. Surg Endosc. 2004;18:407–11.PubMedCrossRef
11.
go back to reference Lebedyev A, Zmora O, Kuriansky J, Rosin D, Khaikin M, Shabtai M, et al. Laparoscopic distal pancreatectomy. Surg Endosc. 2004;18:1427–30.PubMedCrossRef Lebedyev A, Zmora O, Kuriansky J, Rosin D, Khaikin M, Shabtai M, et al. Laparoscopic distal pancreatectomy. Surg Endosc. 2004;18:1427–30.PubMedCrossRef
12.
go back to reference Fernández-Cruz L, Martínez I, Gilabert R, Cesar-Borges G, Astudillo E, Navarro S. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg. 2004;8:493–501.PubMedCrossRef Fernández-Cruz L, Martínez I, Gilabert R, Cesar-Borges G, Astudillo E, Navarro S. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg. 2004;8:493–501.PubMedCrossRef
13.
go back to reference Matsumoto T, Hirano S, Yada K, Himeno Y, Shibata K, Aramaki M, et al. Safety and efficacy laparoscopic distal pancreatectomy for the treatment of pancreatic disease. J Hepatobiliary Pancreat Surg. 2005;12:65–70.PubMedCrossRef Matsumoto T, Hirano S, Yada K, Himeno Y, Shibata K, Aramaki M, et al. Safety and efficacy laparoscopic distal pancreatectomy for the treatment of pancreatic disease. J Hepatobiliary Pancreat Surg. 2005;12:65–70.PubMedCrossRef
14.
go back to reference Mabrut J-Y, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005;137:597–605.PubMedCrossRef Mabrut J-Y, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005;137:597–605.PubMedCrossRef
15.
go back to reference Ayav A, Bresler L, Brunaud L, Boissel P. Laparoscopic approach for solitary insulinoma: a multicentre study. Langenbecks Arch Surg. 2005;390:134–40.PubMedCrossRef Ayav A, Bresler L, Brunaud L, Boissel P. Laparoscopic approach for solitary insulinoma: a multicentre study. Langenbecks Arch Surg. 2005;390:134–40.PubMedCrossRef
16.
go back to reference Dulucq JL, Wintringer P, Stabilini C, Feryn T, Perissat J, Mahajna A. Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution. Surg Endosc. 2005;19:1028–34.PubMedCrossRef Dulucq JL, Wintringer P, Stabilini C, Feryn T, Perissat J, Mahajna A. Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution. Surg Endosc. 2005;19:1028–34.PubMedCrossRef
17.
go back to reference Root J, Nguyen N, Jones B, Mccloud S, Lee J, Nguyen P, et al. Laparoscopic distal pancreatic resection. Am Surg. 2005;71:744–9.PubMed Root J, Nguyen N, Jones B, Mccloud S, Lee J, Nguyen P, et al. Laparoscopic distal pancreatic resection. Am Surg. 2005;71:744–9.PubMed
18.
go back to reference Mori T, Abe N, Sugiyama M. Atomi Y Laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Surg. 2005;12:451–5.PubMedCrossRef Mori T, Abe N, Sugiyama M. Atomi Y Laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Surg. 2005;12:451–5.PubMedCrossRef
19.
go back to reference Corcione F, Marzano E, Cuccurullo D, Caracino V, Pirozzi F, Settembre A. Distal pancreas surgery: outcome for 19 cases managed with a laparoscopic approach. Surg Endosc. 2006;20:1729–32.PubMedCrossRef Corcione F, Marzano E, Cuccurullo D, Caracino V, Pirozzi F, Settembre A. Distal pancreas surgery: outcome for 19 cases managed with a laparoscopic approach. Surg Endosc. 2006;20:1729–32.PubMedCrossRef
20.
go back to reference Velanovich V. The lasso technique for laparoscopic distal pancreatectomy. Surg Endosc. 2006;20:1766–71.PubMedCrossRef Velanovich V. The lasso technique for laparoscopic distal pancreatectomy. Surg Endosc. 2006;20:1766–71.PubMedCrossRef
21.
go back to reference Uranues S, Alimoglu O, Todoric B, Toprak N, Auer T, Rondon L, et al. Laparoscopic resection of the pancreatic tail with splenic preservation. Am J Surg. 2006;192:257–61.PubMedCrossRef Uranues S, Alimoglu O, Todoric B, Toprak N, Auer T, Rondon L, et al. Laparoscopic resection of the pancreatic tail with splenic preservation. Am J Surg. 2006;192:257–61.PubMedCrossRef
22.
go back to reference Toniato A, Meduri F, Foletto M, Avogaro A, Pelizzo M. Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience. World J Surg. 2006;30:1–4.CrossRef Toniato A, Meduri F, Foletto M, Avogaro A, Pelizzo M. Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience. World J Surg. 2006;30:1–4.CrossRef
23.
go back to reference Pierce RA, Spitler JA, Hawkins WG, Strasberg SM, Linehan DC, Halpin VJ, et al. Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc. 2007;21:579–86.PubMedCrossRef Pierce RA, Spitler JA, Hawkins WG, Strasberg SM, Linehan DC, Halpin VJ, et al. Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc. 2007;21:579–86.PubMedCrossRef
24.
go back to reference Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy, results of a prospective non-randomized study from a tertiary center. Surg Endosc. 2007;22:373–7.CrossRef Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy, results of a prospective non-randomized study from a tertiary center. Surg Endosc. 2007;22:373–7.CrossRef
25.
go back to reference Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.PubMedCrossRef Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, et al. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8–13.PubMedCrossRef
26.
go back to reference Pratt W, Maitbel SK, Vanounou T, Callery MP, Vollmer CM. Postoperative pancreatic fistulas are not equivalent after proximal, distal, and central pancreatectomy. J Gastrointest Surg. 2006;10:1264–79.PubMedCrossRef Pratt W, Maitbel SK, Vanounou T, Callery MP, Vollmer CM. Postoperative pancreatic fistulas are not equivalent after proximal, distal, and central pancreatectomy. J Gastrointest Surg. 2006;10:1264–79.PubMedCrossRef
27.
go back to reference Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg. 1988;123:550–3.PubMed Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg. 1988;123:550–3.PubMed
28.
go back to reference Lillemoe KD, Kaushal S, Cameron JL, Sohn TA, Pitt HA, Yeo CJ. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg. 1999;229:693–700.PubMedCrossRef Lillemoe KD, Kaushal S, Cameron JL, Sohn TA, Pitt HA, Yeo CJ. Distal pancreatectomy: indications and outcomes in 235 patients. Ann Surg. 1999;229:693–700.PubMedCrossRef
29.
go back to reference Hamanaka Y, Nishihara K, Hamasaki T, Kawabata A, Yamamoto S, Tsurumi M, et al. Pancreatic juice output after pancreatoduodenectomy in relation to pancreatic consistency, duct size, and leakage. Surgery. 1996;119:281–7.PubMedCrossRef Hamanaka Y, Nishihara K, Hamasaki T, Kawabata A, Yamamoto S, Tsurumi M, et al. Pancreatic juice output after pancreatoduodenectomy in relation to pancreatic consistency, duct size, and leakage. Surgery. 1996;119:281–7.PubMedCrossRef
30.
go back to reference Suzuki Y, Fujino Y, Tanioka Y, Hori Y, Ueda T, Takeyama Y, et al. Randomized clinical trial of ultrasonic dissector or conventional division in distal pancreatectomy for non-fibrotic pancreas. Br J Surg. 1999;86:608–11.PubMedCrossRef Suzuki Y, Fujino Y, Tanioka Y, Hori Y, Ueda T, Takeyama Y, et al. Randomized clinical trial of ultrasonic dissector or conventional division in distal pancreatectomy for non-fibrotic pancreas. Br J Surg. 1999;86:608–11.PubMedCrossRef
31.
go back to reference Bilimoria MM, Cormier JN, Mun Y, Lee JE, Evans DB, Pisters PWT. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg. 2003;90:190–6.PubMedCrossRef Bilimoria MM, Cormier JN, Mun Y, Lee JE, Evans DB, Pisters PWT. Pancreatic leak after left pancreatectomy is reduced following main pancreatic duct ligation. Br J Surg. 2003;90:190–6.PubMedCrossRef
32.
go back to reference Kuroki T, Tajima Y, Kanematsu T. Surgical management for the prevention of pancreatic fistula following distal pancreatectomy. J Hepatobiliary Pancreat Surg. 2005;12:283–5.PubMedCrossRef Kuroki T, Tajima Y, Kanematsu T. Surgical management for the prevention of pancreatic fistula following distal pancreatectomy. J Hepatobiliary Pancreat Surg. 2005;12:283–5.PubMedCrossRef
Metadata
Title
Clinical outcome of laparoscopic distal pancreatectomy
Authors
Yoshiharu Nakamura
Eiji Uchida
Takayuki Aimoto
Satoshi Matsumoto
Hiroshi Yoshida
Takashi Tajiri
Publication date
01-01-2009
Publisher
Springer Japan
Published in
Journal of Hepato-Biliary-Pancreatic Sciences / Issue 1/2009
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI
https://doi.org/10.1007/s00534-008-0007-0

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