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Laparoscopic distal pancreatectomy and pancreatoduodenectomy: is it worthwhile? A meta-analysis of laparoscopic pancreatectomy

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Journal of Hepato-Biliary-Pancreatic Sciences

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Abstract

Background/purpose

This study was performed to evaluate the outcomes of laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD) compared with the open method using meta-analysis.

Methods

A literature search was performed to identify comparative studies of laparoscopic versus open pancreatectomy. Perioperative outcomes were evaluated by meta-analysis using a fixed effect model and random effects model.

Results

Twenty-four studies of LDP and three studies of LPD matched the selection criteria, including 2,904 patients of DP and 109 patients of PD. Compared with ODP, LDP showed statistically significant differences with respect to less blood loss, lower transfusion rates, lower wound infection rates, lower morbidity rates, and shorter hospital stays. LPD showed significantly longer operative times compared with OPD. There was no significant difference in oncological outcomes between laparoscopic pancreatectomy and the open technique.

Conclusions

This meta-analysis included the largest number of patients and number of articles comparing LDP and ODP, and LDP showed significantly better perioperative outcomes. This meta-analysis suggests that LDP is a reasonable operative method for benign tumors and some ductal carcinomas in the pancreas.

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Conflict of interest

The authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Digestive Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Japan

    Masafumi Nakamura & Hiroshi Nakashima

Authors
  1. Masafumi Nakamura
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  2. Hiroshi Nakashima
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Corresponding author

Correspondence to Masafumi Nakamura.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplemented Figure 1. Flow of systematic search of the literature (GIF 17 kb)

Supplemented Figure 2. Operative outcomes of LDP. a Operation time. b Blood loss. c Transfusion rate (GIF 87 kb)

534_2012_578_Fig3_ESM.gif

Supplemented Figure 3. Postoperative recovery of LDP. a First day of flatus. b First day of oral intake. c Hospital stay (GIF 70 kb)

534_2012_578_Fig4_ESM.gif

Supplemented Figure 4. Postoperative complications of LDP. a Overall morbidity. b Mortality rate. c Reoperation rate. d Readmission rate (GIF 109 kb)

534_2012_578_Fig5_ESM.gif

Supplemented Figure 5. Details of postoperative complications of LDP. a Any pancreatic fistula. b Pancreatic fistula, grades B and C (ISGPF). c Wound infection rate (GIF 94 kb)

534_2012_578_Fig6_ESM.gif

Supplemented Figure 6. Meta-analysis of positive resection margin rate and total costs of LDP. a Positive resection margin rate. b Total costs (GIF 43 kb)

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Nakamura, M., Nakashima, H. Laparoscopic distal pancreatectomy and pancreatoduodenectomy: is it worthwhile? A meta-analysis of laparoscopic pancreatectomy. J Hepatobiliary Pancreat Sci 20, 421–428 (2013). https://doi.org/10.1007/s00534-012-0578-7

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  • DOI: https://doi.org/10.1007/s00534-012-0578-7

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