World Journal of Surgery

, Volume 39, Issue 10, pp 2564–2572

Minimally Invasive Distal Pancreatectomy for Cancer: Short-Term Oncologic Outcomes in 1733 Patients

  • Mohamed Abdelgadir Adam
  • Kingshuk Choudhury
  • Paolo Goffredo
  • Shelby D. Reed
  • Dan BlazerIII
  • Sanziana A. Roman
  • Julie A. Sosa
Original Scientific Report

DOI: 10.1007/s00268-015-3138-x

Cite this article as:
Adam, M.A., Choudhury, K., Goffredo, P. et al. World J Surg (2015) 39: 2564. doi:10.1007/s00268-015-3138-x

Abstract

Background

Data from high-volume institutions suggest that minimally invasive distal pancreatectomy (MIDP) provides favorable perioperative outcomes and adequate oncologic resection for pancreatic cancer; however, these outcomes may not be generalizable. This study examines patterns of use and short-term outcomes from MIDP (laparoscopic or robotic) versus open distal pancreatectomy (ODP) for pancreatic adenocarcinoma in the United States.

Methods

Adult patients undergoing distal pancreatectomy were identified from the National Cancer Database, 2010–2011. Multivariable modeling was applied to compare short-term outcomes from MIDP versus ODP for pancreatic adenocarcinoma.

Results

1733 patients met inclusion criteria: 535 (31 %) had MIDP and 1198 (69 %) ODP. Use of MIDP increased 43 % between 2010 and 2011; the conversion rate from MIDP to ODP was 23 %. MIDP cases were performed at 215 hospitals, with 85 % of hospitals performing <10 cases overall. After adjustment, pancreatic adenocarcinoma patients undergoing MIDP versus ODP had a similar likelihood of complete resection (OR 1.48, p = 0.10), number of lymph nodes removed (RR 1.01, p = 0.91), and 30-day readmission rate (OR 1.02, p = 0.96); however, length of stay was shorter (RR 0.84, p < 0.01).

Conclusions

Use of MIDP for cancer is increasing, with most centers performing a low volume of these procedures. Use of MIDP for body and tail pancreatic adenocarcinoma appears to have short-term outcomes that are similar to those of open procedures with the benefit of a shorter hospital stay. Larger studies with longer follow-up are needed.

Copyright information

© Société Internationale de Chirurgie 2015

Authors and Affiliations

  • Mohamed Abdelgadir Adam
    • 1
  • Kingshuk Choudhury
    • 2
  • Paolo Goffredo
    • 3
  • Shelby D. Reed
    • 3
  • Dan BlazerIII
    • 4
  • Sanziana A. Roman
    • 1
  • Julie A. Sosa
    • 1
    • 3
  1. 1.Section of Endocrine Surgery, Department of SurgeryDuke University Medical CenterDurhamUSA
  2. 2.Department of BiostatisticsDuke UniversityDurhamUSA
  3. 3.Duke Clinical Research InstituteDurhamUSA
  4. 4.Division of Advanced GI and Oncologic Surgery, Department of SurgeryDuke University Medical CenterDurhamUSA

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