Système gastro-intestinal et digestif

Abstrait

Laparoscopic versus Open Distal Pancreatectomy: Comparative Analysis of Clinical Outcomes at a Single Institution

Nicolás Jarufe, Pedro P. Soto, Vanessa Ahumada, Jose P. Salinas, Jose L. Galindo, Jean-Phillipe Bächler, Pablo Achurra, Rolando A. Rebolledo, Juan F. Guerra, Jorge Martinez

Background: Distal pancreatectomy (DP) is a standard operation for many pancreatic diseases located to the left of the superior mesenteric vein. Advances in technology have made laparoscopic distal pancreatectomy (LDP) a safe and feasible procedure. In this study, we reviewed our experience with LDP and compared with open distal pancreatectomy (ODP) for the management of benign and malignant lesions. Materials and Methods: A retrospective review of medical records of 93 patients subjected to a DP (ODP=36; LDP=57) for pancreatic tumors between 2001-2015 in the Department of Digestive Surgery of Pontificia Universidad Católica de Chile. In each patient clinical and surgical characteristic, postoperative evolution and histopathologic examination was analyzed. Results: LDP was associated with significantly less operative blood loss (300 ml vs. 50 ml; p=0.007), higher spleen preservation rate (52.6% vs. 19.2%; p=0.002) and shorter hospital stay (5 days vs. 8 days; p<0.001). There were no significant differences in the incidence of postoperative complications between the two groups Conclusions: LDP is a safe and feasible procedure for DP resections. LDP offers advantages over ODP in terms of reduction of operative blood loss, higher spleen preservation rate and shorter hospital stay.