Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach

Butturini, Giovanni; Partelli, Stefano; Crippa, Stefano; Malleo, Giuseppe; Rossini, Roberto; Casetti, Luca; Melotti, Gianluigi; Piccoli, Micaela; Pederzoli, Paolo; Bassi, Claudio

doi:10.1007/s00464-011-1634-0

Cited by 37 publications

(26 citation statements)

References 28 publications

(56 reference statements)

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“…Several retrospective, single-center and multicenter studies have compared the outcomes between LDP and open distal pancreatectomy (ODP) [2,3,28,42,[64][65][66][67][68][69][70][71][72][73][74]. They indicated the superiority of LDP regarding blood loss, postoperative complications, such as surgical site infections, the recovery of physical function, and postoperative hospital stay.…”

Section: Laparoscopic Operationsmentioning

confidence: 99%

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

et al. 2016

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Postoperative pancreatic fistula (POPF) is the most frequent and serious complication after distal pancreatectomy (DP) and often leads to other postoperative complications. Numerous studies have been conducted to clarify the risk factors for POPF after DP, and to also determine effective prophylactic treatments. In this article, we review the current evidence on the risk factors for POPF after DP, and also provide new evidence to support the currently implemented prophylactic measures against POPF after DP. The patient-related and surgery-related risk factors and risk factors specific to staplers are discussed. Several studies have suggested that a thick pancreas is a risk factor for POPF using a stapler and that a higher stapler height or pancreatoenteric anastomosis might be useful for preventing POPF when transecting a thick pancreas. Various methods, such as stapler closure, procedures that may be performed in addition to stapler closure, pancreatoenteric anastomosis, pancreatic transection devices, laparoscopic surgery, pancreatic stenting, stump coverage, and somatostatin analogs, have been tested and in comparison with conventional procedures in case-control studies and randomized, controlled trials. Although some studies have shown the superiority of these methods to the conventional procedures, a consensus on precautionary measures that can be taken against POPF remains to be established. Further investigation is necessary to develop a reliable strategy for preventing POPF and to improve the outcomes of patients after DP.

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Section: Laparoscopic Operationsmentioning

confidence: 99%

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

et al. 2016

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“…Marangos et al [33] found that the 3-year survival [5] 6.4/8.8 a 0%/3% 25%/41% 0%/7% 18%/20% 3.2/4.3 a 37%/45% 6%/7% N/A Soh et al [6] 5 [7] 8/9 0 48.2/45.2% 9.3%/9.6% 29.7%/13.7% 3.9/4.0 4.7%/2.7% N/A N/A Cho et al [8] 16%/54% (> 7d) 0.5%/1% 12%/15% 1%/3% 23%/27% 40%/58% (> 3.5 cm)…”

Section: Oncologic Outcomesmentioning

confidence: 99%

“…As a result, the application of laparoscopy to pancreatectomy has been slower compared to other abdominal procedures. As surgeons become more adept at advanced laparoscopy, there is increasing evidence demonstrating not only the safety and feasibility of laparoscopic pancreatic [3] 42/76 27.3/26.5 NS 35.7%/22.4% 304/281 375/375 11.9% Mehta et al [4] 30/30 N/A N/A 70%/30% a 188/226 294/729 a N/A Limongelli et al [5] 16/29 26.4/27.1 NS 31%/14% 204/160 a 160/365 a 6.0% Soh et al [6] 10/21 25/21 NS N/A 383/330 275/600 a N/A Butturini et al [7] 43/73 N/A N/A 44.2%/11% a 180/180 N/A 0.0% Cho et al [8] 254/439 NS NS 34%/10% a NS 24%/54% (> 300cc) 9.4% Aly et al [9] 40/35 21/21 N/A 32%/8% a 342/250 a 363/606 a 10.0% DiNorcia et al [10] 71/192 N/A NS 15.5%/15.6% 250/270 a 150/900 a 25.3% Jayaraman et al [11] 107/236 27/27 N/A 21%/14% 194/163 a 150/350 a 30.0% Kooby et al [12] 23/189 28.5/26.2 NS N/A 238/230 422/790 a 17.0% Vijan et al [13] 100/100 27.4/27.9 NS 25%/N/A 214/208 171/519 a 4.0% Baker et al [14] 27/85 N/A NS N/A 236/253 219.4/612.6 a 3.6% Finan et al [15] 44/104 28.3/26.9 NS 2%/2.7% 156/200 a 157/719 a 4.1% Nakamura et al [16] 21 [17] 7/4 29.5/29 N/A 100%/100% 182/152 214/362 0.0% Eom et al [18] 31 [19] 93 [20] 14/19 N/A NS N/A 290.7/213.8 a 247.1/400.3 7.0% Misawa et al [21] 8/9 N/A N/A 12.5%/0% 255/205 14/307 a 0.0% Tang et al [22] 9/5 N/A NS 55.6%/0% 180/210 100/450 a 0.0% Teh et al [23] 12 [24] 15/15 N/A N/A 0%/0% N/A N/A 20.0% Fernández-Cruz et al [25] 5/41…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and shortterm oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. Key words: Laparoscopy; Distal pancreatectomy; Pancreaticoduodenectomy; Robotic pancreatectomy; Enucleation Core tip: This review discusses recent advances in laparoscopic distal pancreatectomy (LDP), minimally invasive pancreaticoduodenectomy (MIPD), and enucleation. Recent studies show that LDP have improved perioperative recovery and equivalent oncologic outcomes. Studies on MIPD demonstrate that it is safe in terms of intra-operative outcomes, post-operative recovery and early oncologic outcomes; however, it requires advanced laparoscopic skills. Laparoscopic enucleation has become the operation of choice for small benign tumours that are away from the main pancreatic duct, especially insulinomas. We also summarize key results in pre-operative, perioperative and post-operative outcomes from contemporary series comparing open and laparoscopic pancreatic resections in the tables.

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“…Barlett [29] and Butturini [30] works instead do not agree with the utility of LDP for PC treatment. Whereas the first articles underlines the excessive operative time, explaining that this result was because of the few cases they studied, concluding that this technique should be practiced by expert surgeons; instead the second article doubts about the utility of LDP for malignant cancers, as the anatomic structure of pancreas would not allow to eradicate the tumors fully as they would be too extended.…”

Section: Resultsmentioning

confidence: 91%

Laparoscopic pancreatectomy: Did the indications change? A review from literature

Sperlongano

Esposito

et al. 2015

International Journal of Surgery

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Pancreatic Cancer (PC) is the fourth cause of death for tumors in Western countries. Symptoms are not specific, and can vary according to the tumor size and place. Diagnostic workup includes CA 19-9, CT and MRI. Surgery is the only treatment for PC, associated to radio-chemo therapy. Laparoscopic approaches are actually used for PC treatment in few specialized centers, and could be an alternative to laparotomic surgery. The aim of our study is to evaluate the efficacy of laparoscopy for PC treatment compared to laparotomy. We reviewed 19 articles in literature to assess the feasibility and efficacy of Laparoscopic Distal Pancreatectomy (LDP) and Laparoscopic Pancreaticoduodenectomy (LPD). The results have shown that LDP is nowadays a safe technique, and the outcomes are comparable to laparotomic surgery. Regarding to LPD instead, results are controversial and the data are still not sufficient to consider this technique as a valid alternative to laparotomic surgery.

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Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach

Cited by 37 publications

References 28 publications

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

Attempts to prevent postoperative pancreatic fistula after distal pancreatectomy

Laparoscopic pancreatectomy: Indications and outcomes

Laparoscopic pancreatectomy: Did the indications change? A review from literature

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