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Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches.

Publication ,  Conference
Kooby, DA; Gillespie, T; Bentrem, D; Nakeeb, A; Schmidt, MC; Merchant, NB; Parikh, AA; Martin, RCG; Scoggins, CR; Ahmad, S; Kim, HJ; Park, J ...
Published in: Ann Surg
September 2008

OBJECTIVES: To compare perioperative outcomes of laparoscopic left-sided pancreatectomy (LLP) with traditional open left-sided pancreatectomy (OLP) in a multicenter experience. SUMMARY AND BACKGROUND DATA: LLP is being performed more commonly with limited data comparing results with outcomes from OLP. METHODS: Data from 8 centers were combined for all cases performed between 2002-2006. OLP and LLP cohorts were matched by age, American Society of Anesthesiologists, resected pancreas length, tumor size, and diagnosis. Multivariate analysis was performed using binary logistic regression. RESULTS: Six hundred sixty-seven LPs were performed, with 159 (24%) attempted laparoscopically. Indications were solid lesion in 307 (46%), cystic in 295 (44%), and pancreatitis in 65 (10%) cases. Positive margins occurred in 51 (8%) cases, 335 (50%) had complications, and significant leaks occurred in 108 (16%). Conversion to OLP occurred in 20 (13%) of the LLPs. In the matched comparison, 200 OLPs were compared with 142 LLPs. There were no differences in positive margin rates (8% vs. 7%, P = 0.8), operative times (216 vs. 230 minutes, P = 0.3), or leak rates (18% vs. 11%, P = 0.1). LLP patients had lower average blood loss (357 vs. 588 mL, P < 0.01), fewer complications (40% vs. 57%, P < 0.01), and shorter hospital stays (5.9 vs. 9.0 days, P < 0.01). By MVA, LLP was an independent factor for shorter hospital stay (P < 0.01, odds ratio 0.33, 95% confidence interval 0.19-0.56). CONCLUSIONS: In selected patients, LLP is associated with less morbidity and shorter LOS than OLP. Pancreatic fistula rates are similar for OLP and LLP. LLP is appropriate for selected patients with left-sided pancreatic pathology.

Duke Scholars

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

September 2008

Volume

248

Issue

3

Start / End Page

438 / 446

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Pancreatic Fistula
  • Pancreatic Diseases
  • Pancreatectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
  • Female
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Kooby, D. A., Gillespie, T., Bentrem, D., Nakeeb, A., Schmidt, M. C., Merchant, N. B., … Hawkins, W. G. (2008). Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. In Ann Surg (Vol. 248, pp. 438–446). United States. https://doi.org/10.1097/SLA.0b013e318185a990
Kooby, David A., Theresa Gillespie, David Bentrem, Attila Nakeeb, Max C. Schmidt, Nipun B. Merchant, Alex A. Parikh, et al. “Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches.” In Ann Surg, 248:438–46, 2008. https://doi.org/10.1097/SLA.0b013e318185a990.
Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, Merchant NB, et al. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. In: Ann Surg. 2008. p. 438–46.
Kooby, David A., et al. “Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches.Ann Surg, vol. 248, no. 3, 2008, pp. 438–46. Pubmed, doi:10.1097/SLA.0b013e318185a990.
Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, Merchant NB, Parikh AA, Martin RCG, Scoggins CR, Ahmad S, Kim HJ, Park J, Johnston F, Strouch MJ, Menze A, Rymer J, McClaine R, Strasberg SM, Talamonti MS, Staley CA, McMasters KM, Lowy AM, Byrd-Sellers J, Wood WC, Hawkins WG. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg. 2008. p. 438–446.

Published In

Ann Surg

DOI

EISSN

1528-1140

Publication Date

September 2008

Volume

248

Issue

3

Start / End Page

438 / 446

Location

United States

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Pancreatic Fistula
  • Pancreatic Diseases
  • Pancreatectomy
  • Middle Aged
  • Male
  • Laparoscopy
  • Humans
  • Female