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BMC Gastroenterology

, 15:182

First Online: 22 December 2015Received: 12 June 2015Accepted: 10 December 2015


BackgroundLaparoscopic distal pancreatectomy LDP showed advantage of perioperation outcomes for benign and low-grade tumor of the pancreas. The application of LDP for pancreatic ductal adenocarcinoma PDAC didn’t gain popular acceptance and the number of LDP for PDAC remains low. We designed a case-matched study to analysis the short- and long-term outcomes of the patients undergoing either Laparoscopic distal pancreatectomy or open distal pancreatectomy for PDAC.

MethodFrom 2003 to 2013, 17 patients were underwent LDP and 34 patients were underwent ODP for PDAC were matched by tumor size, age and body mass index BMI. The two groups’ demographic information, perioperative outcomes and survival data were compared.

ResultsBaseline characteristics were comparable between the LDP and ODP groups. The intraoperative blood loss, first flatus, first oral intake and postoperative hospital stay were significantly less in LDP group than ODP group 50 ml vs400ml, P = 0.000; 3d vs 4d, P = 0.001; 3d vs 4d, P = 0.003; 13d vs 15.5d, P = 0.022. The mean operation time, overall postoperative morbidity and postoperative pancreatic fistula rates were similar in the two groups. 5 patients 29.4 % in LDP group and 7 patients 20.6 % in ODP group underwent extended resections. There were no significant differences in tumor sizes 3.5 cm vs 3.9 cm, P = 0.664 and number of harvested lymph nodes 9 vs8 P = 0.534. The median overall survival for both groups was 14.0 months. Cox proportional hazards analysis showed extended resections, R1 resection, perineural invasion and tumor differentiation were associated with worse survival.

ConclusionLDP is technically feasible and safe for PDAC in selected patients and the short-term oncologic outcomes were not inferior to ODP in this small sample study. However the long-term oncologic safety of LDP for PDAC has to be further evaluated by multicenter or randomized controlled trials.

KeywordsPancreatic ductal adenocarcinoma Laparoscopic surgery Open surgery Distal pancreatectomy Case matched study AbbreviationsASAAmerican Society of Anesthesiologists

BMIbody mass index

DMdiabetes mellitus

LDPlaparoscopic distal pancreatectomy

ODPopen distal pancreatectomy

PDACpancreatic ductal adenocarcinoma

POPFpostoperative pancreatic fistulae

SMAsuperior mesenteric artery

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Autor: Miaozun Zhang - Ren Fang - Yiping Mou - Ronggao Chen - Xiaowu Xu - Renchao Zhang - Jiafei Yan - Weiwei Jin - Harsha Ajood

Fuente: https://link.springer.com/

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