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Surgical Endoscopy

, Volume 30, Issue 8, pp 3409–3418 | Cite as

Laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: results of a multicenter cohort study on 196 patients

  • Mushegh A. SahakyanEmail author
  • Airazat M. Kazaryan
  • Majd Rawashdeh
  • David Fuks
  • Mark Shmavonyan
  • Sven-Petter Haugvik
  • Knut Jørgen Labori
  • Trond Buanes
  • Bård Ingvald Røsok
  • Dejan Ignjatovic
  • Mohammad Abu Hilal
  • Brice Gayet
  • Song Cheol Kim
  • Bjørn Edwin
Article

Abstract

Background

Laparoscopy is widely accepted as a feasible option for distal pancreatectomy. However, the experience in laparoscopic distal pancreatectomy (LDP) for pancreatic ductal adenocarcinoma (PDAC) is limited to a small number of studies, reported by expert centers. The present study aimed to evaluate perioperative and oncological outcomes after LDP for PDAC in a large, multicenter cohort of patients.

Methods

A retrospective analysis of the data on 196 patients with histologically verified PDAC, operated at Oslo University Hospital—Rikshospitalet (Oslo, Norway), Asan Medical Center (Seoul, Republic of Korea), Institut Mutualiste Montsouris (Paris, France) and University Hospital Southampton (Southampton, UK) between January 2002 and April 2015 was conducted. The patients with standard (SLDP) and extended (i.e., en bloc with adjacent organ, ELDP) resections were compared in terms of perioperative and oncological outcomes.

Results

Out of 196 LDP procedures, 191 (97.4 %) were completed through laparoscopy, while five (2.6 %) were converted to open surgery. ELDP was performed in 30 (15.7 %) cases. Sixty-one (31.9 %) patients experienced postoperative complications, including 48 (25.1 %) with pancreatic fistula. The rate of clinically relevant fistula (grade B/C) was 15.7 %. Median postoperative hospital stay was 8 (2–63) days. Median follow-up was 16 months. Median survival was 31.3 months (95 % CI 22.9–39.6). Three- and 5-year actuarial survival rates were 42.4 and 30 %, respectively. SLDP was associated with significantly higher survival compared with ELDP (p = 0.032).

Conclusions

LDP seems to be a feasible and safe procedure, providing satisfactory oncological outcomes in patients with PDAC.

Keywords

Laparoscopy Ductal adenocarcinoma Pancreatectomy Outcomes Survival 

Notes

Compliance with ethical standards

Disclosures

Mushegh A. Sahakyan, Airazat M. Kazaryan, Majd Rawashdeh, David Fuks, Mark Shmavonyan, Sven-Petter Haugvik, Knut-Jørgen Labori, Trond Buanes, Bård Ingvald Røsok, Dejan Ignjatovic, Mohammad Abu Hilal, Brice Gayet, Song Cheol Kim and Bjørn Edwin have no conflicts of interest or financial ties to disclose.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Mushegh A. Sahakyan
    • 1
    • 2
    • 3
    Email author
  • Airazat M. Kazaryan
    • 1
    • 4
  • Majd Rawashdeh
    • 5
  • David Fuks
    • 6
    • 7
  • Mark Shmavonyan
    • 1
    • 2
  • Sven-Petter Haugvik
    • 8
    • 9
  • Knut Jørgen Labori
    • 8
  • Trond Buanes
    • 2
    • 8
  • Bård Ingvald Røsok
    • 8
  • Dejan Ignjatovic
    • 10
  • Mohammad Abu Hilal
    • 5
  • Brice Gayet
    • 6
    • 7
  • Song Cheol Kim
    • 11
  • Bjørn Edwin
    • 1
    • 2
    • 8
  1. 1.The Intervention CentreOslo University Hospital - RikshospitaletOsloNorway
  2. 2.Institute of Clinical Medicine, Medical FacultyUniversity of OsloOsloNorway
  3. 3.Department of Surgery No 1Yerevan State Medical University After M. HeratsiYerevanArmenia
  4. 4.Department of SurgeryFinnmark HospitalKirkenesNorway
  5. 5.University Hospital Southampton NHS Foundation TrustSouthamptonUK
  6. 6.Department of Digestive Diseases, Institut Mutualiste MontsourisUniversité Paris DescartesParisFrance
  7. 7.Institut des Systèmes Intelligents et Robotique (ISIR)Université Pierre et Marie CurieParisFrance
  8. 8.Department of Hepato-Pancreato-Billiary SugeryOslo University Hospital-RikshospitaletOsloNorway
  9. 9.Department of SurgeryVestre Viken Hospital TrustDrammenNorway
  10. 10.Department of Digestive Surgery, Akershus University HospitalUniversity of OsloLørenskogNorway
  11. 11.Division of Hepato-Biliary and Pancreatic Surgery, Department of SurgeryUniversity of Ulsan College of Medicine and Asan Medical CenterSeoulSouth Korea

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