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World Journal of Surgery

, Volume 38, Issue 2, pp 476–483 | Cite as

Oncological Feasibility of Laparoscopic Distal Pancreatectomy for Adenocarcinoma: A Single-Institution Comparative Study

  • S. Rehman
  • S. K. P. John
  • R. Lochan
  • B. C. Jaques
  • D. M. Manas
  • R. M. Charnley
  • J. J. French
  • S. A. White
Article

Abstract

Background

Laparoscopic distal pancreatectomy (LDP) is performed increasingly for pancreatic pathology in the body and tail of the pancreas. However, only few reports have compared its oncological efficacy with open distal pancreatectomy (ODP). We compared these two techniques in patients with pancreatic ductal adenocarcinoma.

Methods

From a prospectively maintained database, all patients who underwent either LDP or ODP for adenocarcinoma in the body and tail of the pancreas between January 2008 and December 2011 were compared. Data were analysed using SPSS® v19 utilising standard tests. A p value <0.05 was considered significant.

Results

Of 101 patients who underwent distal pancreatectomy, 22 had histologically confirmed adenocarcinoma (LDP n = 8, ODP n = 14). Both groups were well matched for age and the size of tumour (22 vs. 32 mm, p = 0.22). Intraoperative blood loss was 306 ml compared with 650 ml for ODP (p = 0.152). A longer operative time was noted for LDP (376 vs. 274 min, p < 0.05). Total length of stay was shorter for LDP compared with ODP (8 vs. 12 days, p = 0.05). The number of postoperative pancreatic fistulas were similar (LDP n = 2 vs. ODP n = 3, p = 0.5). Complete resection (R0) was achieved in 88 % of LDP (n = 7) compared with 86 % of ODP (n = 12). The median number of lymph nodes harvested was 16 for LDP versus 14 for ODP. Overall 3-year survival also was similar: LDP = 82 %, ODP = 74 % (p = 0.89).

Conclusions

From an oncological perspective, LDP is a viable procedure and its results are comparable to ODP for ductal adenocarcinomas arising in the body and tail of the pancreas.

Keywords

Pancreatic Fistula Distal Pancreatectomy Pancreatic Ductal Adenocarcinoma Laparoscopic Distal Pancreatectomy Postoperative Pancreatic Fistula 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of interest

None.

Funding

None.

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Copyright information

© Société Internationale de Chirurgie 2013

Authors and Affiliations

  • S. Rehman
    • 1
  • S. K. P. John
    • 1
  • R. Lochan
    • 1
  • B. C. Jaques
    • 1
  • D. M. Manas
    • 1
  • R. M. Charnley
    • 1
  • J. J. French
    • 1
  • S. A. White
    • 1
  1. 1.Department of Hepatobiliary and Transplantation SurgeryFreeman HospitalNewcastle upon TyneUK

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