Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma

John A. Stauffer, Alessandro Coppola, Kabir Mody, Horacio J. Asbun

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Background: Laparoscopic distal pancreatectomy (LDP) has been shown to have short-term benefits over open distal pancreatectomy (ODP). Its application for pancreatic ductal adenocarcinoma (PDAC) remains controversial. Methods: From 1995 to 2014, 72 patients underwent distal pancreatectomy for PDAC at a single institution and were included in the study. Postoperative and long-term outcomes of patients undergoing LDP (n = 44) or ODP (n = 28) were compared. Results: LDP was associated with less blood loss (332 vs. 874 mL, p = 0.0012) and lower transfusion rates than ODP (18.2 vs. 50 %, p = 0.0495). Operative time was similar (254 vs. 266 min) for LDP and ODP; five patients (11.4 %) required conversion to ODP. Pancreatic fistulas (13.6 vs. 7.1 %) and major complications (13.6 vs. 25 %), were similar between LDP and ODP, respectively. Length of hospital stay (5.1 vs. 9.4 days, p = 0.0001) and time to initiate adjuvant therapy (69.4 vs. 95.6 days, p = 0.0441) was shorter for LDP than ODP. Tumor characteristics were similar but LDP was associated with more resected lymph nodes than ODP (25.9 vs. 12.7, p = 0.0001). One-, three-, and five-year survival rates were similar between LDP (69, 41, and 41 %, respectively) and ODP (78, 44, and 32 %, respectively). Conclusion: LDP is associated with less blood loss and need for blood transfusion, shorter hospital stay, and faster time to initiate adjuvant therapy than ODP for patients with PDAC. Postoperative outcomes and long-term survival are similar between the two groups. LDP appears to be safe in the treatment of patients with PDAC.

Original languageEnglish (US)
Pages (from-to)1477-1484
Number of pages8
JournalWorld Journal of Surgery
Volume40
Issue number6
DOIs
StatePublished - Jun 1 2016

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Pancreatectomy
Adenocarcinoma
Length of Stay
Pancreatic Fistula

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

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Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma. / Stauffer, John A.; Coppola, Alessandro; Mody, Kabir; Asbun, Horacio J.

In: World Journal of Surgery, Vol. 40, No. 6, 01.06.2016, p. 1477-1484.

Research output: Contribution to journalArticle

Stauffer, John A. ; Coppola, Alessandro ; Mody, Kabir ; Asbun, Horacio J. / Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma. In: World Journal of Surgery. 2016 ; Vol. 40, No. 6. pp. 1477-1484.
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title = "Laparoscopic Versus Open Distal Pancreatectomy for Pancreatic Adenocarcinoma",
abstract = "Background: Laparoscopic distal pancreatectomy (LDP) has been shown to have short-term benefits over open distal pancreatectomy (ODP). Its application for pancreatic ductal adenocarcinoma (PDAC) remains controversial. Methods: From 1995 to 2014, 72 patients underwent distal pancreatectomy for PDAC at a single institution and were included in the study. Postoperative and long-term outcomes of patients undergoing LDP (n = 44) or ODP (n = 28) were compared. Results: LDP was associated with less blood loss (332 vs. 874 mL, p = 0.0012) and lower transfusion rates than ODP (18.2 vs. 50 {\%}, p = 0.0495). Operative time was similar (254 vs. 266 min) for LDP and ODP; five patients (11.4 {\%}) required conversion to ODP. Pancreatic fistulas (13.6 vs. 7.1 {\%}) and major complications (13.6 vs. 25 {\%}), were similar between LDP and ODP, respectively. Length of hospital stay (5.1 vs. 9.4 days, p = 0.0001) and time to initiate adjuvant therapy (69.4 vs. 95.6 days, p = 0.0441) was shorter for LDP than ODP. Tumor characteristics were similar but LDP was associated with more resected lymph nodes than ODP (25.9 vs. 12.7, p = 0.0001). One-, three-, and five-year survival rates were similar between LDP (69, 41, and 41 {\%}, respectively) and ODP (78, 44, and 32 {\%}, respectively). Conclusion: LDP is associated with less blood loss and need for blood transfusion, shorter hospital stay, and faster time to initiate adjuvant therapy than ODP for patients with PDAC. Postoperative outcomes and long-term survival are similar between the two groups. LDP appears to be safe in the treatment of patients with PDAC.",
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AB - Background: Laparoscopic distal pancreatectomy (LDP) has been shown to have short-term benefits over open distal pancreatectomy (ODP). Its application for pancreatic ductal adenocarcinoma (PDAC) remains controversial. Methods: From 1995 to 2014, 72 patients underwent distal pancreatectomy for PDAC at a single institution and were included in the study. Postoperative and long-term outcomes of patients undergoing LDP (n = 44) or ODP (n = 28) were compared. Results: LDP was associated with less blood loss (332 vs. 874 mL, p = 0.0012) and lower transfusion rates than ODP (18.2 vs. 50 %, p = 0.0495). Operative time was similar (254 vs. 266 min) for LDP and ODP; five patients (11.4 %) required conversion to ODP. Pancreatic fistulas (13.6 vs. 7.1 %) and major complications (13.6 vs. 25 %), were similar between LDP and ODP, respectively. Length of hospital stay (5.1 vs. 9.4 days, p = 0.0001) and time to initiate adjuvant therapy (69.4 vs. 95.6 days, p = 0.0441) was shorter for LDP than ODP. Tumor characteristics were similar but LDP was associated with more resected lymph nodes than ODP (25.9 vs. 12.7, p = 0.0001). One-, three-, and five-year survival rates were similar between LDP (69, 41, and 41 %, respectively) and ODP (78, 44, and 32 %, respectively). Conclusion: LDP is associated with less blood loss and need for blood transfusion, shorter hospital stay, and faster time to initiate adjuvant therapy than ODP for patients with PDAC. Postoperative outcomes and long-term survival are similar between the two groups. LDP appears to be safe in the treatment of patients with PDAC.

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