Updates in Surgery

, Volume 68, Issue 3, pp 225–234 | Cite as

Laparoscopic distal pancreatectomy: many meta-analyses, few certainties

  • Claudio Ricci
  • Riccardo Casadei
  • Giovanni Taffurelli
  • Carlo Alberto Pacilio
  • Francesco Minni
Review Article
First Online:
Received:
Accepted:
Part of the following topical collections:
  1. Pancreatic Surgery

Abstract

In recent years, an increasing of the level of evidence occurred with a significant number of meta-analyses. A question remains open: can LDP be considered the “new gold standard” for benign and malignant body–tail pancreatic disease? A systematic literature search was conducted to identify all meta-analyses published up to 2016. The primary endpoint was to evaluate the clinical safety of LDP. The secondary endpoints were to evaluate: the length of hospital stay (LOS), readmission rate, postoperative pancreatic fistula (POPF), overall postoperative morbidity and oncologic safety. Nine studies were found to be suitable for the analysis. Data regarding clinical safety were extractable in all meta-analyses but a “between study” homogeneity was available only in 7. The safety of LDP was sustained by six meta-analyses in benign/low grade of malignancy body–tail pancreatic lesions, by one in ductal adenocarcinoma (PDAC). LDP has a shorter LOS compared to open distal pancreatectomy (ODP), demonstrated by three meta-analyses. Readmission rate in LDP procedures was lower than in ODP; these data are sustained by one meta-analysis. LDP is not inferior to ODP regarding the occurrence of POPF (seven meta-analyses); overall morbidity rate was lower in LDP than ODP for benign or low-grade malignant tumor. The use of the LDP in PDAC is sustained from one study. In conclusion, LDP can be considered a safe alternative to ODP. LDP could have some advantages but the data do not permit to define this procedure as the first choice or as the new gold standard.

Keywords

Distal Pancreatectomy Readmission Rate Weighted Mean Difference Laparoscopic Distal Pancreatectomy Clinical Safety 
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.
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Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.

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Copyright information

© Italian Society of Surgery (SIC) 2016

Authors and Affiliations

  • Claudio Ricci
    • 1
  • Riccardo Casadei
    • 1
  • Giovanni Taffurelli
    • 1
  • Carlo Alberto Pacilio
    • 1
  • Francesco Minni
    • 1
  1. 1.Dipartimento di Scienze Mediche e Chirurgiche (DIMEC)Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-MalpighiBolognaItaly

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