Minimally Invasive Distal Pancreatectomy Techniques: A Contemporary Analysis Exploring Trends, Similarities, and Differences to Open Surgery

Author:

Romero-Hernandez Fernanda,Mohamedaly SarahORCID,Miller Phoebe,Rodriguez NatalieORCID,Calthorpe Lucia,Conroy Patricia C.,Ganjouei Amir Ashraf,Hirose Kenzo,Maker Ajay V.,Nakakura Eric,Corvera Carlos,Kirkwood Kimberly S.,Alseidi Adnan,Adam Mohamed A.

Abstract

Limited contemporary data has compared similarities and differences between total laparoscopic (LDP), hand-assisted (HALDP), and open distal pancreatectomy (ODP). This study aimed to examine similarities and differences in outcomes between these three approaches in a contemporary cohort. Methods: Patients undergoing elective LDP, HALDP, and ODP in the NSQIP dataset (2014–2019) were included. Descriptive statistics and multivariate regression analyses were employed to compare postoperative outcomes. Results: Among 5636 patients, 33.9% underwent LDP, 13.1% HALDP, and 52.9% ODP. Compared with the LDP approach, surgical site infections were more frequent in HALDP and ODP approaches (1.2% vs. 2.6% vs. 2.8%, respectively, p < 0.01). After adjustment, the LDP approach was associated with a significantly lower likelihood of surgical site infection (OR 0.25, p = 0.03) when compared to ODP. There was no difference in the likelihood of surgical site infection when HALDP was compared to ODP (OR 0.59, p = 0.40). Unadjusted operative times were similar between approaches (LDP = 192 min, HALDP = 193 min, ODP = 191 min, p = 0.59). After adjustment, the LDP approach had a longer operative time (+10.3 min, p = 0.04) compared to ODP. There was no difference in the adjusted operative time between HALDP and ODP approaches (+5.4 min, p = 0.80). Conclusions: Compared to ODP, LDP was associated with improved surgical site infection rates and slightly longer operative times. There was no difference in surgical site infection rates between ODP and HALDP. Surgeon comfort and experience should decide the operative approach, but it is important to discuss the differences between these approaches with patients.

Publisher

MDPI AG

Subject

Cancer Research,Oncology

Reference24 articles.

1. The Evolution of Laparoscopy and the Revolution in Surgery in the Decade of the 1990s;J. Soc. Laparoendosc. Surg.,2008

2. Twenty Years of Laparoscopic Cholecystectomy: Philippe Mouret—March 17, 1987;J. Soc. Laparoendosc. Surg.,2008

3. Laparoscopic Distal Pancreatectomy: Evolution of a Technique at a Single Institution;J. Am. Coll. Surg.,2010

4. Laparoscopic Distal Pancreatectomy;J. Am. Coll. Surg.,2009

5. Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: A systematic review and me-ta-analysis;Ann. Surg.,2012

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