Updates in Surgery

, Volume 70, Issue 1, pp 41–45 | Cite as

Laparoscopic pancreatic resections in two medium-sized medical centres

  • Gian Luca Baiocchi
  • Edoardo Rosso
  • Andrea Celotti
  • Giuseppe Zimmiti
  • Alberto Manzoni
  • Marco Garatti
  • Guido Tiberio
  • Nazario Portolani
Original Article

Abstract

To analyze the clinical outcomes of patients undergoing minimally invasive surgery for pancreatic neoplasms, in two medium-volume centers in Northern Italy, a retrospective chart review was performed in the operative registries, searching for patients who had undergone pancreatic surgery via laparoscopy, irrespective of the final pathological nature of the resected neoplasm. For each case, a standard data extraction form was completed and the following data was extracted: age and sex, type of resection, estimated blood loss, length of the operation, number of harvested nodes, post-operative pancreatic fistula, major post-operative complications, mortality and final pathological diagnosis. The systematic literature research was also undertaken and the reported results were analyzed. A total of 55 cases were recorded, including 39 distal pancreatectomies and 16 pancreaticoduodenectomies. The most frequent indications leading to surgery were ductal adenocarcinoma (26 pts) and cystic neoplasm (22 pts). No post-operative death occurred in this series; pancreatic fistula occurred in 64% of distal pancreatectomies and 22% of pancreaticoduodenectomies. The mean operating times were 178′ and 572′, respectively. Both distal pancreatectomy and pancreaticoduodenectomy proved to be feasible and were safely performed by laparoscopy, in two centers with medium-volume pancreatic caseload.

Keywords

Pancreas Laparoscopy Pancreatic fistula Mortality Morbidity 

Notes

Acknowledgements

Prof. Gian Luca Baiocchi had full access to the data in the study and takes responsibility for the completeness of the data and the accuracy of the data analysis. All authors gratefully acknowledge the financial support from a research Grant awarded by the RicerChiAmo Foundation.

Compliance with ethical standards

Conflict of interest

The Authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants and/or animals

This article does not involve any studies with animals.

Informed consent

For this type of study formal consent is not required.

References

  1. 1.
    Gagner M, Pomp A, Herrera MF (1996) Early experience with laparoscopic resections of islet cell tumors. Surgery 120:1051–1054 (PMID: 8957494) CrossRefPubMedGoogle Scholar
  2. 2.
    Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ et al (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591.  https://doi.org/10.1016/j.surg.2016.11.014 (Epub 2016 Dec 28) CrossRefPubMedGoogle Scholar
  3. 3.
    Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213 (PMID:15273542) CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Montagnini AL, Røsok BI, Asbun HJ, Barkun J, Besselink MG, Boggi U, Conlon KC, Fingerhut A, Han HS et al (2017) Standardizing terminology for minimally invasive pancreatic resection. HPB (Oxford) 19(3):182–189.  https://doi.org/10.1016/j.hpb.2017.01.006 CrossRefGoogle Scholar
  5. 5.
    Liang S, Hameed U, Jayaraman S (2014) Laparoscopic pancreatectomy: Indications and outcomes. World J Gastroenterol 20(39):14246–14254. http://www.wjgnet.com/1007-9327/full/v20/i39/14246.htm.  https://doi.org/10.3748/wjg.v20.i39.14246
  6. 6.
    Davidson RN, Wall RA (2001) Prevention and management of infections in patients without a spleen. Clin Microbiol Infect 7:657–660 (PMID: 11843905) CrossRefPubMedGoogle Scholar
  7. 7.
    Mekeel KL, Moss AA, Reddy KS, Mulligan DC, Harold KL (2011) Laparoscopic distal pancreatectomy: does splenic preservation affect outcomes? Surg Laparosc Endosc Percutan Tech 21:362–365 (PMID: 22002275) CrossRefPubMedGoogle Scholar
  8. 8.
    Aly MY, Tsutsumi K, Nakamura M, Sato N, Takahata S, Ueda J, Shimizu S, Redwan AA, Tanaka M (2010) Comparative study of laparoscopic and open distal pancreatectomy. J Laparoendosc Adv Surg Tech A 20:435–440.  https://doi.org/10.1089/lap.2009.0412 (PMID: 20518689) CrossRefPubMedGoogle Scholar
  9. 9.
    DiNorcia J, Schrope BA, Lee MK, Reavey PL, Rosen SJ, Lee JA, Chabot JA, Allendorf JD (2010) Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg 14:1804–1812.  https://doi.org/10.1007/s11605-010-1264-1 (PMID: 20589446) CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC, Kim HJ, Ahmad S, Cho CS, Parikh AA, Chu CK, Hamilton NA, Doyle CJ, Pinchot S, Hayman A, McClaine R, Nakeeb A, Staley CA, McMasters KM, Lillemoe KD (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(779–785):786–787.  https://doi.org/10.1016/j.jamcollsurg.2009.12.033 (PMID: 20421049) Google Scholar
  11. 11.
    Limongelli P, Belli A, Russo G, Cioffi L, D’Agostino A, Fantini C, Belli G (2012) Laparoscopic and open surgical treatment of left-sided pancreatic lesions: clinical outcomes and costeffectiveness analysis. Surg Endosc 26:1830–1836.  https://doi.org/10.1007/s00464-011-2141-z (PMID: 22258300) CrossRefPubMedGoogle Scholar
  12. 12.
    Soh YF, Kow AW, Wong KY, Wang B, Chan CY, Liau KH, Ho CK (2012) Perioperative outcomes of laparoscopic and open distal pancreatectomy: our institution’s 5-year experience. Asian J Surg 35:29–36 (PMID: 22726561) CrossRefPubMedGoogle Scholar
  13. 13.
    Butturini G, Partelli S, Crippa S, Malleo G, Rossini R, Casetti L, Melotti GL, Piccoli M, Pederzoli P, Bassi C (2011) Perioperative and long-term results after left pancreatectomy: a single-institution, non-randomized, comparative study between open and laparoscopic approach. Surg Endosc 25:2871–2878.  https://doi.org/10.1007/s00464-011-1634-0 (PMID: 21424200) CrossRefPubMedGoogle Scholar
  14. 14.
    Kneuertz PJ, Patel SH, Chu CK, Fisher SB, Maithel SK, Sarmiento JM, Weber SM, Staley CA, Kooby DA (2012) Laparoscopic distal pancreatectomy: trends and lessons learned through an 11-year experience. J Am Coll Surg 215:167–176.  https://doi.org/10.1016/j.jamcollsurg.2012.03.023 (PMID: 22632910) CrossRefPubMedGoogle Scholar
  15. 15.
    Fisher SB, Kooby DA (2013) Laparoscopic pancreatectomy for malignancy. J Surg Oncol 107:39–50.  https://doi.org/10.1002/jso.23253 (PMID: 22991263) CrossRefPubMedGoogle Scholar
  16. 16.
    Jayaraman S, Gonen M, Brennan MF, D’Angelica MI, DeMatteo RP, Fong Y, Jarnagin WR, Allen PJ (2010) Laparoscopic distal pancreatectomy: evolution of a technique at a single institution. J Am Coll Surg 211:503–509.  https://doi.org/10.1016/j.jamcollsurg.2010.06.010 (PMID: 20868976) CrossRefPubMedGoogle Scholar
  17. 17.
    Mehta SS, Doumane G, Mura T, Nocca D, Fabre JM (2012) Laparoscopic versus open distal pancreatectomy: a single-institution case-control study. Surg Endosc 26:402–407.  https://doi.org/10.1007/s00464-011-1887-7 (PMID: 21909859) CrossRefPubMedGoogle Scholar
  18. 18.
    Asbun HJ, Stauffer JA (2012) Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the Accordion Severity Grading System. J Am Coll Surg 215:810–819.  https://doi.org/10.1016/j.jamcollsurg.2012.08.006 (PMID: 22999327) CrossRefPubMedGoogle Scholar
  19. 19.
    Kuroki T, Adachi T, Okamoto T, Kanematsu T (2012) A nonrandomized comparative study of laparoscopy-assisted pancreaticoduodenectomy and open pancreaticoduodenectomy. Hepatogastroenterology 59:570–573 (PMID: 21940382) CrossRefPubMedGoogle Scholar
  20. 20.
    Zureikat AH, Breaux JA, Steel JL, Hughes SJ (2011) Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg 15:1151–1157.  https://doi.org/10.1007/s11605-011-1530-x (PMID: 21538192) CrossRefPubMedGoogle Scholar
  21. 21.
    Cho A, Yamamoto H, Nagata M, Takiguchi N, Shimada H, Kainuma O, Souda H, Gunji H, Miyazaki A, Ikeda A, Tohma T, Matsumoto I (2009) Comparison of laparoscopy-assisted and open pylorus-preserving pancreaticoduodenectomy for periampullary disease. Am J Surg 198:445–449.  https://doi.org/10.1016/j.amjsurg.2008.12.025 (PMID: 19342003) CrossRefPubMedGoogle Scholar
  22. 22.
    Stauffer JA, Asbun HJ (2015) Minimally invasive pancreatic surgery. Semin Oncol 42(1):123–133.  https://doi.org/10.1053/j.seminoncol.2014.12.011 (review, PMID: 25726057) CrossRefPubMedGoogle Scholar

Copyright information

© Italian Society of Surgery (SIC) 2018

Authors and Affiliations

  1. 1.Department of Medical and Surgical Sciences, Surgical ClinicUniversity of BresciaBresciaItaly
  2. 2.UOC Chirurgia Generale, Fondazione PoliambulanzaBresciaItaly
  3. 3.III Chirurgia-Spedali Civili di BresciaBresciaItaly

Personalised recommendations