Comparison of open with laparoscopic distal pancreatectomy

A single institution's transition over a 7-year period

John A. Stauffer, Armando Rosales-Velderrain, Ross F. Goldberg, Steven P. Bowers, Horacio J. Asbun

Research output: Contribution to journalArticle

49 Citations (Scopus)

Abstract

Objectives Many studies have shown laparoscopic distal pancreatectomy (LDP) to have benefits over open distal pancreatectomy (ODP). This institution made a unique abrupt transition from an exclusively open approach to a preference for the laparoscopic technique. This study aimed to compare outcomes in patients undergoing LDP and ODP, respectively, over the period of transition. Methods A retrospective review of all patients undergoing LDP (n = 82) or ODP (n = 90) was performed. Surrogate oncologic markers for the subgroup of patients with malignant disease were also studied. Results The ODP and LDP groups were well matched with regard to demographics, comorbidities and tumour characteristics. Significant differences were noted in favour of the LDP group in which decreases were seen in estimated blood loss (<0.001), need for packed red blood cell transfusions (<0.001), length of hospital stay (<0.001) and intensive care unit stay (<0.001). No other significant differences in the occurrence of complications or oncologic outcomes were seen. Rates of Grade B and C fistulae were 10% and 6% in the ODP and LDP groups, respectively. Grade III-V complications occurred in 20% and 13% of the ODP and LDP groups, respectively. Conclusions Laparoscopic distal pancreatectomy continues to compare favourably with ODP when well-matched patient series are reviewed. The results show a decreased need for blood transfusions and hospital resources in LDP. Additionally, there may be oncologic advantages associated with LDP compared with ODP in pancreatic malignancies.

Original languageEnglish (US)
Pages (from-to)149-155
Number of pages7
JournalHPB
Volume15
Issue number2
DOIs
StatePublished - Feb 2013

Fingerprint

Pancreatectomy
Length of Stay
Erythrocyte Transfusion

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Stauffer, J. A., Rosales-Velderrain, A., Goldberg, R. F., Bowers, S. P., & Asbun, H. J. (2013). Comparison of open with laparoscopic distal pancreatectomy: A single institution's transition over a 7-year period. HPB, 15(2), 149-155. https://doi.org/10.1111/j.1477-2574.2012.00603.x

Comparison of open with laparoscopic distal pancreatectomy : A single institution's transition over a 7-year period. / Stauffer, John A.; Rosales-Velderrain, Armando; Goldberg, Ross F.; Bowers, Steven P.; Asbun, Horacio J.

In: HPB, Vol. 15, No. 2, 02.2013, p. 149-155.

Research output: Contribution to journalArticle

Stauffer, JA, Rosales-Velderrain, A, Goldberg, RF, Bowers, SP & Asbun, HJ 2013, 'Comparison of open with laparoscopic distal pancreatectomy: A single institution's transition over a 7-year period', HPB, vol. 15, no. 2, pp. 149-155. https://doi.org/10.1111/j.1477-2574.2012.00603.x
Stauffer, John A. ; Rosales-Velderrain, Armando ; Goldberg, Ross F. ; Bowers, Steven P. ; Asbun, Horacio J. / Comparison of open with laparoscopic distal pancreatectomy : A single institution's transition over a 7-year period. In: HPB. 2013 ; Vol. 15, No. 2. pp. 149-155.
@article{8db7dd85cc0242d29115b94724290daf,
title = "Comparison of open with laparoscopic distal pancreatectomy: A single institution's transition over a 7-year period",
abstract = "Objectives Many studies have shown laparoscopic distal pancreatectomy (LDP) to have benefits over open distal pancreatectomy (ODP). This institution made a unique abrupt transition from an exclusively open approach to a preference for the laparoscopic technique. This study aimed to compare outcomes in patients undergoing LDP and ODP, respectively, over the period of transition. Methods A retrospective review of all patients undergoing LDP (n = 82) or ODP (n = 90) was performed. Surrogate oncologic markers for the subgroup of patients with malignant disease were also studied. Results The ODP and LDP groups were well matched with regard to demographics, comorbidities and tumour characteristics. Significant differences were noted in favour of the LDP group in which decreases were seen in estimated blood loss (<0.001), need for packed red blood cell transfusions (<0.001), length of hospital stay (<0.001) and intensive care unit stay (<0.001). No other significant differences in the occurrence of complications or oncologic outcomes were seen. Rates of Grade B and C fistulae were 10{\%} and 6{\%} in the ODP and LDP groups, respectively. Grade III-V complications occurred in 20{\%} and 13{\%} of the ODP and LDP groups, respectively. Conclusions Laparoscopic distal pancreatectomy continues to compare favourably with ODP when well-matched patient series are reviewed. The results show a decreased need for blood transfusions and hospital resources in LDP. Additionally, there may be oncologic advantages associated with LDP compared with ODP in pancreatic malignancies.",
author = "Stauffer, {John A.} and Armando Rosales-Velderrain and Goldberg, {Ross F.} and Bowers, {Steven P.} and Asbun, {Horacio J.}",
year = "2013",
month = "2",
doi = "10.1111/j.1477-2574.2012.00603.x",
language = "English (US)",
volume = "15",
pages = "149--155",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "2",

}

TY - JOUR

T1 - Comparison of open with laparoscopic distal pancreatectomy

T2 - A single institution's transition over a 7-year period

AU - Stauffer, John A.

AU - Rosales-Velderrain, Armando

AU - Goldberg, Ross F.

AU - Bowers, Steven P.

AU - Asbun, Horacio J.

PY - 2013/2

Y1 - 2013/2

N2 - Objectives Many studies have shown laparoscopic distal pancreatectomy (LDP) to have benefits over open distal pancreatectomy (ODP). This institution made a unique abrupt transition from an exclusively open approach to a preference for the laparoscopic technique. This study aimed to compare outcomes in patients undergoing LDP and ODP, respectively, over the period of transition. Methods A retrospective review of all patients undergoing LDP (n = 82) or ODP (n = 90) was performed. Surrogate oncologic markers for the subgroup of patients with malignant disease were also studied. Results The ODP and LDP groups were well matched with regard to demographics, comorbidities and tumour characteristics. Significant differences were noted in favour of the LDP group in which decreases were seen in estimated blood loss (<0.001), need for packed red blood cell transfusions (<0.001), length of hospital stay (<0.001) and intensive care unit stay (<0.001). No other significant differences in the occurrence of complications or oncologic outcomes were seen. Rates of Grade B and C fistulae were 10% and 6% in the ODP and LDP groups, respectively. Grade III-V complications occurred in 20% and 13% of the ODP and LDP groups, respectively. Conclusions Laparoscopic distal pancreatectomy continues to compare favourably with ODP when well-matched patient series are reviewed. The results show a decreased need for blood transfusions and hospital resources in LDP. Additionally, there may be oncologic advantages associated with LDP compared with ODP in pancreatic malignancies.

AB - Objectives Many studies have shown laparoscopic distal pancreatectomy (LDP) to have benefits over open distal pancreatectomy (ODP). This institution made a unique abrupt transition from an exclusively open approach to a preference for the laparoscopic technique. This study aimed to compare outcomes in patients undergoing LDP and ODP, respectively, over the period of transition. Methods A retrospective review of all patients undergoing LDP (n = 82) or ODP (n = 90) was performed. Surrogate oncologic markers for the subgroup of patients with malignant disease were also studied. Results The ODP and LDP groups were well matched with regard to demographics, comorbidities and tumour characteristics. Significant differences were noted in favour of the LDP group in which decreases were seen in estimated blood loss (<0.001), need for packed red blood cell transfusions (<0.001), length of hospital stay (<0.001) and intensive care unit stay (<0.001). No other significant differences in the occurrence of complications or oncologic outcomes were seen. Rates of Grade B and C fistulae were 10% and 6% in the ODP and LDP groups, respectively. Grade III-V complications occurred in 20% and 13% of the ODP and LDP groups, respectively. Conclusions Laparoscopic distal pancreatectomy continues to compare favourably with ODP when well-matched patient series are reviewed. The results show a decreased need for blood transfusions and hospital resources in LDP. Additionally, there may be oncologic advantages associated with LDP compared with ODP in pancreatic malignancies.

UR - http://www.scopus.com/inward/record.url?scp=84872198184&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84872198184&partnerID=8YFLogxK

U2 - 10.1111/j.1477-2574.2012.00603.x

DO - 10.1111/j.1477-2574.2012.00603.x

M3 - Article

VL - 15

SP - 149

EP - 155

JO - HPB

JF - HPB

SN - 1365-182X

IS - 2

ER -