Surgical Endoscopy

, Volume 22, Issue 5, pp 1334–1338 | Cite as

Clinical outcomes compared between laparoscopic and open distal pancreatectomy

  • B. W. Eom
  • J.-Y. JangEmail author
  • S. E. Lee
  • H.-S. Han
  • Y.-S. Yoon
  • S.-W. Kim



Laparoscopic surgery for pancreatic disease has gained increasing popularity. A laparoscopic distal pancreatectomy is technically simple and has been adopted as the preferred method in many centers. However, there is limited information on the outcomes of the laparoscopic surgery compared with open surgery. Therefore, this study aimed to investigate the clinical outcomes of laparoscopic distal pancreatectomy and to evaluate its efficacy compared with open distal pancreatectomy.


From February 1995 to March 2006, 31 patients underwent laparoscopic distal pancreatectomy, and 167 patients underwent open distal pancreatectomy at Seoul National University Hospital and Bundang Seoul National University Hospital. A case–control design was used with 2:1 matching to compare laparoscopic surgery with open surgery. Among 167 patients who underwent open distal pancreatectomy, 62 patients whose age, gender, and pathology were similar to those of patients who underwent laparoscopic surgery were selected for this study. The operation time, intraoperative transfusion requirements, duration of postoperative hospitalization, complications, mortality, recurrence, and hospital charges were analyzed.


There were no significant differences in operation time, rate of intraoperative transfusions, complications, recurrence, or mortality between the two groups. Laparoscopic distal pancreatectomy was associated with a statistically significant shorter hospital stay (11.5 days vs 13.5 days; p = 0.049), but with more expensive hospital charges than open distal pancreatectomy (p < 0.01).


Laparoscopic distal pancreatectomy is a clinically safe and effective procedure for benign and borderline pancreatic tumors.


Distal pancreatectomy Laparoscopic distal pancreatectomy 



This study was supported by a grant from the National R&D Program for Cancer Control, Ministry of Health & Welfare, Republic of Korea (No. 0520320).


  1. 1.
    Kim HJ, D’Angelica M, Hiotis SP, Shoup M, Weber SM (2007) Laparoscopic staging for liver, biliary, pancreas, and gastric cancer. Curr Probl Surg 44:228–269PubMedCrossRefGoogle Scholar
  2. 2.
    Butturini G, Crippa S, Bassi C, Salvia R, Piccoli M, Pederzoli P (2007) The role of laparoscopy in advanced pancreatic cancer diagnosis. Dig Surg 24:33–37PubMedCrossRefGoogle Scholar
  3. 3.
    Ahmed SI, Bochkarev V, Oleynikov D, Sasson AR (2006) Patients with pancreatic adenocarcinoma benefit from staging laparoscopy. J Laparoendosc Adv Surg Tech A 16:458–463PubMedCrossRefGoogle Scholar
  4. 4.
    Hauters P, Weerts J, Navez B, Champault G, Peillon C, Totte E, Barthelemy R, Siriser F (2004) Laparoscopic treatment of pancreatic pseudocysts. Surg Endosc 18:1645–1648PubMedGoogle Scholar
  5. 5.
    Bhandarkar DS, Bhanushali PJ (2003) Laparoscopic drainage of a peripancreatic tuberculous abscess. Surg Endosc 17:831PubMedCrossRefGoogle Scholar
  6. 6.
    Pierce RA, Spitler JA, Hawkins WG, Strasberg SM, Linehan DC, Halpin VJ, Eagon JC, Brunt LM, Frisella MM, Matthews BD (2007) Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc 21:579–586PubMedCrossRefGoogle Scholar
  7. 7.
    Ammori BJ, Baghdadi S (2006) Minimally invasive pancreatic surgery: the new frontier? Curr Gastroenterol Rep 8:132–142PubMedCrossRefGoogle Scholar
  8. 8.
    Toniato A, Meduri F, Foletto M, Avogaro A, Pelizzo M (2006) Laparoscopic treatment of benign insulinomas localized in the body and tail of the pancreas: a single-center experience. World J Surg 30:1916–1919PubMedCrossRefGoogle Scholar
  9. 9.
    Melotti G, Butturini G, Piccoli M, Casetti L, Bassi C, Mullineris B, Lazzaretti MG, Pederzoli P (2007) Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients. Ann Surg 246:77–82PubMedCrossRefGoogle Scholar
  10. 10.
    Uranues S, Alimoglu O, Todoric B, Toprak N, Auer T, Rondon L, Sauseng G, Pfeifer J (2006) Laparoscopic resection of the pancreatic tail with splenic preservation. Am J Surg 192:257–261PubMedCrossRefGoogle Scholar
  11. 11.
    Palanivelu C, Jani K, Senthilnathan P, Parthasarathi R, Rajapandian S, Madhankumar MV (2007) Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg 205:222–230PubMedCrossRefGoogle Scholar
  12. 12.
    Dulucq JL, Wintringer P, Mahajna A (2006) Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc 20:1045–1050PubMedCrossRefGoogle Scholar
  13. 13.
    Fabre JM, Dulucq JL, Vacher C, Lemoine MC, Wintringer P, Nocca D, Burgel JS, Domergue J (2002) Is laparoscopic left pancreatic resection justified? Surg Endosc 16:1358–1361PubMedCrossRefGoogle Scholar
  14. 14.
    Kim SW, Youk EG, Park YH (1997) Comparison of pancreatogastrostomy and pancreatojejunostomy after pancreatoduodenectomy performed by one surgeon. World J Surg 21:640–643PubMedCrossRefGoogle Scholar
  15. 15.
    Soper NJ, Brunt LM, Dunnegan DL, Meininger TA (1994) Laparoscopic distal pancreatectomy in the porcine model. Surg Endosc 8:57–60PubMedCrossRefGoogle Scholar
  16. 16.
    Gagner M, Pomp A (1997) Laparoscopic pancreatic resection: is it worthwhile? J Gastrointest Surg 1:20–25PubMedCrossRefGoogle Scholar
  17. 17.
    Cuschieri SA, Jakimowicz JJ (1998) Laparoscopic pancreatic resections. Semin Laparosc Surg 5:168–179PubMedGoogle Scholar
  18. 18.
    Park A, Schwartz R, Tandan V, Anvari M (1999) Laparoscopic pancreatic surgery. Am J Surg. 177:158–163PubMedCrossRefGoogle Scholar
  19. 19.
    Fernandez-Cruz L, Saenz A, Astudillo E, Pantoja JP, Uzcategui E, Navarro S (2002) Laparoscopic pancreatic surgery in patients with chronic pancreatitis. Surg Endosc 16:996–1003PubMedCrossRefGoogle Scholar
  20. 20.
    Velanovich V (2006) Case–control comparison of laparoscopic versus open distal pancreatectomy. J Gastrointest Surg 10:95–98PubMedCrossRefGoogle Scholar
  21. 21.
    Fernandez-Cruz L, Herrera M, Saenz A, Pantoja JP, Austudillo E, Sierra M (2001) Laparoscopic pancreatic surgery in patients with neuroendocrine tumours: indications and limits. Best Pract Res Clin Endocrinol Metab 15:161–175PubMedCrossRefGoogle Scholar
  22. 22.
    Dai MH, Zhao YP, Liao O, Liu ZW, Guo JC, Cong L (2006) Laparoscopic distal pancreatectomy: current indications and surgical results. Zhonghua Wai Ke Za Zhi 1:1022–1025Google Scholar
  23. 23.
    Fahy BN, Frey CF, Ho HS, Beckett L, Bold RJ (2001) Morbidity, mortality, and technical factors of distal pancreatectomy. Am J Surg 183:237–241CrossRefGoogle Scholar
  24. 24.
    Mallet GP, Vachon A (1943) Pancreatites chroniqes gauches. Masson, ParisGoogle Scholar
  25. 25.
    Robey E, Mullen JT, Schwab CW (1982) Blunt trisection of the pancreas treated by distal pancreatectomy, splenic salvage, and hyperalimentation: four cases and review of the literature. Ann Surg 196:695–699PubMedCrossRefGoogle Scholar
  26. 26.
    Yamaguchi K, Noshiro H, Yokohata K, Nakano K, Watanabe M, Ohtani K, Chijiiwa K, Tanaka M (2001) Is there any benefit of preservation of the spleen in distal pancreatectomy? Int Surg 86:162–168PubMedGoogle Scholar
  27. 27.
    Warshaw AL (1997) Techniques of preserving the spleen with distal pancreatectomy. Surgery 121:974CrossRefGoogle Scholar
  28. 28.
    Kaneko H, Takagi S, Joubara N, Yamazaki K, Kubota Y, Tsuchiya M, Otsuka Y, Shiba T (2004) Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein. J Hepatobiliary Pancreat Surg 11:397–401PubMedCrossRefGoogle Scholar
  29. 29.
    Mori T, Abe N, Sugiyama M, Atomi Y (2005) Laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Surg 12:451–455PubMedCrossRefGoogle Scholar
  30. 30.
    Fernandez-Cruz L, Martinez I, Gilabert R, Cesar-Borges G, Astudillo E, Navarro S (2004) Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasm of the pancreas. J Gastrointest Surg 8:493–501PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  • B. W. Eom
    • 1
  • J.-Y. Jang
    • 1
    Email author
  • S. E. Lee
    • 1
  • H.-S. Han
    • 1
  • Y.-S. Yoon
    • 1
  • S.-W. Kim
    • 1
  1. 1.Department of SurgerySeoul National University College of MedicineSeoulKorea

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