Laparoscopic Versus Open Central Pancreatectomy: Clinical Outcomes and Pancreatic Function Analysis

Yiping Mou, MD, FACS, Xiaowu Xu, MD, Renchao Zhang, MD, Weiwei Jin, MD, Jiafei Yan, MD, Miaozun Zhang, MD. Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University

Background The studies on laparoscopic central pancreatectomy (LCP) versus open central pancreatectomy (OCP) have not been presented in the literature to date. This study aimed to compare perioperative outcomes of patients undergoing LCP and OCP and to assess the pancreatic function after LCP.

Methods A retrospective study was performed for patients who underwent LCP or OCP between 1997 and 2013. The patients’ demographic data, operative results, pathological reports, hospital courses, morbidity and mortality, and follow-up data (including pancreatic function) were compared between these two groups.

Results Forty-one central pancreatectomy (laparoscopic=12, open=29) were performed during the study period. The operating time (282.9±28.6 vs 280.4±74.8min, P=0.876) were similar between these two groups. The intraoperative blood loss [50(30-300)vs 250(50-1200)ml, P=0.000]was less in the LCP group. Mortality, morbidity(58.3% vs 65.5%, P=0.938), pancreatic fistula rates(≥grade B:25% vs 37.9%, P=0.665)were similar between the two groups. There were no significant difference in endocrine(9.1% vs 16%)or exocrine(0 vs 8.0%)dysfunction between the two groups(P>0.05). For the LCP group, the comparison of the pre- and postoperative endocrine or exocrine function didn't reveal any significant difference in terms of fasting blood glucose, insulin, C-peptide, Fecal elastase-1(P>0.05).

Conclusions LCP is both a safe and feasible approach with pancreatic function-preserving.

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