Pancreatic Body and Tail Cancer: Is Laparoscopic Surgery an Effective Method?

Abstract

Background: Laparoscopic treatment of pancreas body and tail cancers is still a matter of debate. The aim of this study is to evaluate the safety and feasibility of laparoscopic distal pancreatectomy (LDP) in pancreas cancer patients. Material & Methods: The data of 108 patients who underwent distal pancreatectomy for pancreatic cancer were evaluated. Patients were categorized into two groups by operation method: laparoscopic distal pancreatectomy [LDP; 35 cases] and open distal pancreatectomy [ODP; 73 cases]. Patient characteristics, surgical findings, short- and long-term results were compared. Results: The operation time was significantly shorter in ODP (p<0.001). The blood loss (100 ml [min-max: 50-800]) of the LDP was significantly lower than ODP (200 [min-max: 100-800]) (p<0.001). There was no significant difference between the groups in terms of postoperative complications. The median hospital stay (6 [min-max: 4-32]) was found to be significantly higher in ODP (p=0.024). Oncological findings (tumor size; harvested lymph node; metastatic lymph node; perineural invasion; lymphovascular invasion) of patients with pancreatic adenocarcinoma were similar. There was no significant difference in the overall survival rates of the two groups (Log-rank=0.066; p=0.798). Conclusion: Although the preference of LDP in pancreatic cancer patients prolongs the operation time, it reduces hospital stay and blodd loss. Overall complication rates and oncologic outcomes appear to be similar. In conclusion, LDP is a feasible and safe method in pancreatic cancer patients. Keywords: laparoscopy, pancreatic neoplasms, pancreas cancer, pancreatectomy, pancreas surgery