Comparative study of laparoscopic and open distal pancreatectomy / 第二军医大学学报

ABSTRACT

Objective To assess the feasibility, safety and efficacy of laparoscopic distal pancreatectomy (LDP) by comparing LDP with open distal pancreatectomy (ODP). Methods The clinical data of 68 patients with pancreatic body or tail diseases, who received distal pancreatectomy from May 2011 to February 2012, were retrospectively analyzed. LDP was performed in 16 cases and ODP in 52 cases. The baseline clinical data and the intraoperative and postoperative findings were compared between the two groups. Results There was no death in the two groups. The sex ratio, age, body mass index,tumor diameter and total hospital costs were not significantly different between the two groups. The incision length of LDP group was significantly shorter than that of ODP group (\[3.50±1.34\] cm vs \[17.94±2.12\] cm, P<0.001). The operative duration of LDP group was significantly longer than that of ODP group (\[145.63±56.80\] min vs \[87.21±32.06\] min,P<0.001). Postoperative hospital stay of LDP and ODP groups were (5.06±1.24) d and (8.06±2.53) d (P<0.001), time in bed after surgery were (1.31±0.68) d and (2.94±0.80) d (P<0.001), and postoperative fasting time were (1.31±0.57) d and (2.86±1.34) d (P<0.001), respectively. Estimated blood loss of LDP and ODP groups were (318.75±227.21) ml and (306.35±378.36) ml (P=0.898), respectively. Four patients had pancreatic leakages and 1 had peritoneal effusion in LDP group. Twelve patients had pancreatic leakages and 3 had peritoneal effusions in ODP group, with one having both pancreatic leakage and peritoneal effusion. There were no significant differences in the incidence of pancreatic leakage and peritoneal effusion between the two groups. The postoperative pain score was mainly 1-2 in LDP group and 2-3 in ODP group, with significant differences found between the two groups (P<0.001). Conclusion LDP is feasible and safe in treating benign or borderline disease of pancreatic body and tail. Compared to ODP,LDP has the advantage of less trauma and pain, quicker recovery without increasing the total costs.