Laparoscopic distal pancreatectomy versus laparoscopic central pancreatectomy for benign or low-grade malignant tumors in the pancreatic neck.
Central pancreatectomy
Diabetes
Distal pancreatectomy
Laparoscopic
Journal
Langenbeck's archives of surgery
ISSN: 1435-2451
Titre abrégé: Langenbecks Arch Surg
Pays: Germany
ID NLM: 9808285
Informations de publication
Date de publication:
12 Sep 2023
12 Sep 2023
Historique:
received:
29
11
2022
accepted:
05
09
2023
medline:
14
9
2023
pubmed:
13
9
2023
entrez:
12
9
2023
Statut:
epublish
Résumé
Laparoscopic distal pancreatectomy (LDP) and laparoscopic central pancreatectomy (LCP) are two surgical methods that can remove pancreatic neck lesions. However, their benefits remain controversial. We aimed to compare the benefits and limitations of LDP and LCP. In total, 50 patients who underwent LDP (n = 34) or LCP (n =16) between January 2014 and November 2019 were retrospectively reviewed using our database. We analyzed their preoperative characteristics, operative data, pathological features, and postoperative outcomes. The baseline features of patients did not differ significantly between the two groups (P < 0.05). Compared with the LDP group, the LCP group showed significantly prolonged operation time (392 ± 144 vs. 269 ± 130 min, P = 0.007), time to oral intake (3.8 ± 1.3 vs. 2.8 ± 0.9 days, P = 0.017), and hospital stay (19.6 ± 5.1 vs. 15.4 ± 4.1 days, P = 0.008) as well as increased hospital expenses (10.1 ± 6.2 vs. 6.6 ± 1.5 WanRMB, P = 0.023). However, no significant differences were observed in conversion rate (0/16 vs. 0/34), blood loss (154 ± 93 vs. 211 ± 170 mL, P = 0.224), postoperative white blood cell count (10.3 ± 2.7 vs. 11.1 ± 3.1, P = 0.432), first random blood glucose level after operation (8.2 ± 2.1 vs. 8.6 ± 2.6 mmol/L, P = 0.696), and ascites amylase level on day 3 after operation (5212 [3110-14,176] vs. 3142 [604-13,761] U/L, P = 0.167) between the two groups. Moreover, no significant differences were noted in the incidence of postoperative diabetes (1/16 vs. 5/34) between the two groups. However, LCP was associated with significantly higher incidences of pancreatic fistula grades B and C (P = 0.005) and postoperative hemorrhage (P = 0.031). Compared with the LCP, LDP is a useful and safer technique for benign or low-grade malignant tumors in the pancreatic neck.
Identifiants
pubmed: 37700188
doi: 10.1007/s00423-023-03096-9
pii: 10.1007/s00423-023-03096-9
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
355Informations de copyright
© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.
Références
Casadei R, Ingaldi C, Ricci C, De Raffele E, Alberici L, Minni F (2022) Converted laparoscopic distal pancreatectomy: is there an impact on patient outcome and total cost? Langenbeck's Arch Surg 407(4):1499–1506
doi: 10.1007/s00423-021-02427-y
Schlöricke E, Nolde J, Hoffmann M, Roblick U, Bruch HP (2011) Laparoscopic spleen-preserving distal pancreatectomy. Langenbeck's Arch Surg 396(7):1119–1123
doi: 10.1007/s00423-011-0755-1
Dokmak S et al (2017) The largest European single-center experience: 300 laparoscopic pancreatic resections. J Am Coll Surg 225(2):226–34.e2
doi: 10.1016/j.jamcollsurg.2017.04.004
pubmed: 28414116
Gao H et al (2019) Central pancreatectomy for early-stage pancreatic ductal adenocarcinoma: a single-center case-control study. Langenbeck's Arch Surg 404(2):175–182
doi: 10.1007/s00423-019-01766-1
Goudard Y et al (2014) Reappraisal of central pancreatectomy a 12-year single-center experience. JAMA Surg 149(4):356–363
doi: 10.1001/jamasurg.2013.4146
pubmed: 24740703
Machado MA, Surjan RC, Epstein MG, Makdissi FF (2013) Laparoscopic central pancreatectomy: a review of 51 cases. Surg Laparosc Endosc Percutan Tech 23(6):486–490
doi: 10.1097/SLE.0b013e3182a4bf69
pubmed: 24300922
Balzano G, Zerbi A, Veronesi P, Cristallo M, Di Carlo V (2003) Surgical treatment of benign and borderline neoplasms of the pancreatic body. Dig Surg 20(6):506–510
doi: 10.1159/000073646
pubmed: 14506331
Xu SB, Zhu YP, ZhouW XK, Mou YP (2013) Patients get more long-term benefit from central pancreatectomy than distal resection: a meta-analysis. Eur J Surg Oncol 39(6):567–574
doi: 10.1016/j.ejso.2013.02.003
pubmed: 23465182
DiNorcia J et al (2010) Better preservation of endocrine function after central versus distal pancreatectomy for mid-gland lesions. Surgery 148(6):1247–1254
doi: 10.1016/j.surg.2010.09.003
pubmed: 21134558
Sa Cunha A, Rault A, Beau C, Collet D, Masson B (2007) Laparoscopic central pancreatectomy: single institution experience of 6 patients. Surgery 142(3):405–409
doi: 10.1016/j.surg.2007.01.035
pubmed: 17723894
Song KB et al (2015) Laparoscopic central pancreatectomy for benign or low-grade malignant lesions in the pancreatic neck and proximal body. Surg Endosc 29(4):937–946
doi: 10.1007/s00464-014-3756-7
pubmed: 25149632
Zhang RC et al (2017) Comparison of clinical outcomes and quality of life between laparoscopic and open central pancreatectomy with pancreaticojejunostomy. Surg Endosc 31(11):4756–4763
doi: 10.1007/s00464-017-5552-7
pubmed: 28424909
Solcia E, Kloppel G, Sobin LH (2000) Histological typing of tumours of endocrine pancreas. In: Solcia E, Kloppel G, Sobin LH (eds) Histological Typing of Endocrine Tumours (International Histological Classification of Tumours). Springer, Berlin
doi: 10.1007/978-3-642-59655-1
Ding Z et al (2020) Comparative analysis of the safety and feasibility of laparoscopic versus open caudate lobe resection. Langenbeck's Arch Surg 405(6):737–744
doi: 10.1007/s00423-020-01928-6
Dokmak S et al (2014) Pure laparoscopic middle pancreatectomy: single-center experience with 13 cases. Surg Endosc 28(5):1601–1606
doi: 10.1007/s00464-013-3357-x
pubmed: 24380987
Lv A, Qian HG, Qiu H, Wu JH, Hao CY (2018) Is central pancreatectomy truly recommendable? A 9-year single-center experience. Dig Surg 35(6):532–538
doi: 10.1159/000485806
pubmed: 29275422
Reber HA (2007) Middle pancreatectomy: why I rarely do it. J Gastrointest Surg 11(6):730–732
doi: 10.1007/s11605-007-0188-x
pubmed: 17530335
Yin X, Luo D, Huang Y, Huang M (2019) Advantages of laparoscopic left hemihepatectomy: a meta-analysis. Medicine 98(23):e15929
doi: 10.1097/MD.0000000000015929
pubmed: 31169712
pmcid: 6571277
Dragomir MP, Sabo AA, Petrescu GED, Li Y, Dumitrascu T (2019) Central pancreatectomy: a comprehensive, up-to-date meta-analysis. Langenbeck's Arch Surg 404(8):945–958
doi: 10.1007/s00423-019-01829-3
Iacono C et al (2013) Systematic review of central pancreatectomy and meta-analysis of central versus distal pancreatectomy. Br J Surg 100(7):873–885
doi: 10.1002/bjs.9136
pubmed: 23640664
Xiao W, Zhu J, Peng L, Hong L, Sun G, Li Y (2018) The role of central pancreatectomy in pancreatic surgery: a systematic review and meta-analysis. HPB 20(10):896–904
doi: 10.1016/j.hpb.2018.05.001
pubmed: 29886106