Laparoscopic pancreatic resections in two medium-sized medical centres
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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.
KeywordsPancreas Laparoscopy Pancreatic fistula Mortality Morbidity
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.
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.
For this type of study formal consent is not required.
- 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
- 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
- 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.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.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
- 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.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
- 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
- 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