Journal
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
Volume 28, Issue 9, Pages 2584-2591Publisher
SPRINGER
DOI: 10.1007/s00464-014-3507-9
Keywords
Pancreatic cancer; Splenopancreatectomy; Laparoscopy; Radical resection; Comparative study
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Funding
- Beijing Nova Program [2012077]
- Beijing Special Clinical Application Program [Z121107001012133]
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Laparoscopic distal splenopancreatectomy (DSP) is an effective and safe surgical modality for treating benign and borderline distal pancreatic tumors, but rarely for pancreatic cancer. This study aimed to examine the feasibility, effectiveness, and safety of laparoscopic versus laparotomic DSP in pancreatic body-tail cancer (PBTC) patients. Thirty-four PBTC patients were consecutively and retrospectively hospitalized for elective laparoscopic DSP (n = 11) or laparotomy (n = 23) between January 2007 and December 2011. The primary outcome measure was mean overall survival (OS). All patients underwent DSP via laparoscopy or laparotomy as scheduled and were followed-up for 12-72 months. The two groups showed statistically similar mean operative time (laparoscopy vs. laparotomy, 150 +/- A 54 vs. 160 +/- A 48 min), median volume of intraoperative bleeding (100 [50-400] vs. 150 [50-350] ml), and rate of postoperative pancreatic fistula (18.2 vs. 21.7 %). The laparoscopy group had a significantly shorter median duration of hospitalization (5 [3-12] vs. 8 [7-22] d, P < 0.05). All patients had a clear resection margin and showed statistically similar tumor size (2.8 +/- A 1.5 vs. 3.1 +/- A 1.7 cm), number of lymph nodes dissected (14.8 +/- A 4.5 vs. 16.1 +/- A 5.7), and mean OS (42.0 +/- A 8.6 vs. 54.0 +/- A 5.8 mo, P > 0.05). Laparoscopic DSP is a feasible, effective, and safe alternative to laparotomy in carefully selected PBTC patients and is associated with a more rapid postoperative recovery.
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