Laparoscopic versus open distal splenopancreatectomy for the treatment of pancreatic body and tail cancer: a retrospective, mid-term follow-up study at a single academic tertiary care institution
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Laparoscopic distal splenopancreatectomy (DSP) is an effective and safe surgical modality for treating benign and borderline distal pancreatic tumors, but rarely for pancreatic cancer. This study aimed to examine the feasibility, effectiveness, and safety of laparoscopic versus laparotomic DSP in pancreatic body-tail cancer (PBTC) patients.
Thirty-four PBTC patients were consecutively and retrospectively hospitalized for elective laparoscopic DSP (n = 11) or laparotomy (n = 23) between January 2007 and December 2011. The primary outcome measure was mean overall survival (OS).
All patients underwent DSP via laparoscopy or laparotomy as scheduled and were followed-up for 12–72 months. The two groups showed statistically similar mean operative time (laparoscopy vs. laparotomy, 150 ± 54 vs. 160 ± 48 min), median volume of intraoperative bleeding (100 [50–400] vs. 150 [50–350] ml), and rate of postoperative pancreatic fistula (18.2 vs. 21.7 %). The laparoscopy group had a significantly shorter median duration of hospitalization (5 [3–12] vs. 8 [7–22] d, P < 0.05). All patients had a clear resection margin and showed statistically similar tumor size (2.8 ± 1.5 vs. 3.1 ± 1.7 cm), number of lymph nodes dissected (14.8 ± 4.5 vs. 16.1 ± 5.7), and mean OS (42.0 ± 8.6 vs. 54.0 ± 5.8 mo, P > 0.05).
Laparoscopic DSP is a feasible, effective, and safe alternative to laparotomy in carefully selected PBTC patients and is associated with a more rapid postoperative recovery.
KeywordsPancreatic cancer Splenopancreatectomy Laparoscopy Radical resection Comparative study
This study was supported by the Beijing Nova Program (Grant No. 2012077) and the Beijing Special Clinical Application Program (Grant No. Z121107001012133).
Drs. Minggen Hu, Guodong Zhao, Fei Wang, Zhiming Zhao, Chenggang Li, Zhipeng Zhou, Dabin Xu, Yong Xu, Dongda Song and Rong Liu have no conflicts of interest or financial ties to disclose.
- 17.Watanabe S, Kobayashi N, Kubota K, Sato T, Kato S, Hosono K, Shimamura T, Inayama Y, Nakajima A, Endo I (2013) A novel scoring system for arterial invasion of pancreatic body and tail cancer based on multidetector row computed tomography and biomarkers. Pancreatology 13:161–169PubMedCrossRefGoogle Scholar
- 18.Song KB, Kim SC, Park JB, Kim YH, Jung YS, Kim MH, Lee SK, Seo DW, Lee SS, Park do H, Han DJ (2011) Single-center experience of laparoscopic left pancreatic resection in 359 consecutive patients: changing the surgical paradigm of left pancreatic resection. Surg Endosc 25:3364–3372PubMedCrossRefGoogle Scholar
- 20.Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, Merchant NB, Parikh AA, Martin RC 2nd, Scoggins CR, Ahmad S, Kim HJ, Park J, Johnston F, Strouch MJ, Menze A, Rymer J, McClaine R, Strasberg SM, Talamonti MS, Staley CA, McMasters KM, Lowy AM, Byrd-Sellers J, Wood WC, Hawkins WG (2008) Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg 248:438–446PubMedGoogle Scholar
- 23.Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC 3rd, Kim HJ, Ahmad S, Cho CS, Parikh AA, Chu CK, Hamilton NA, Doyle CJ, Pinchot S, Hayman A, McClaine R, Nakeeb A, Staley CA, McMasters KM, Lillemoe KD (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(779–785):786–787Google Scholar