Laparoscopic Versus Open Enucleation for Pancreatic Neoplasms: Clinical Outcomes and Pancreatic Function Analysis

Renchao Zhang, MD, Jiafei Yan, MD, Yiping Mou, MD, FACS, Yucheng Zhou, MD, Chaojie Huang, Chao Lu, Ronggao Chen. Department of General Surgery, Sir Run Run Shaw Hospital, Zhejiang University

Background:Enucleation is an alternative procedure for treating benign or lowgrade malignant neoplasms of the pancreas. The studies on laparoscopic enucleation(LE) versus open enucleation(OE) have not been as readily available. This study aimed to compare perioperative outcomes of patients undergoing LE and OE and to assess the pancreatic function after LE.

Methods:A retrospective study was performed for patients who underwent LE or OE between 2001 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:Thirty-nine enucleation (laparoscopic=13, open=26) were performed during the study period. Baseline characteristics were similar between these two groups(P>0.05). There were no significant differences in the operating time (131.9±48.5 vs 158.2±41.8min, P=0.088) between the two groups. The intraoperative blood loss [80(20-450)vs 200(50-1000)ml, P=0.004] was less in the LE group. Mortality, morbidity (30.8% vs 38.5%, P=0.733), pancreatic fistula rates (≥grade B:15.4% vs 11.5%, P=0.777)were similar between the two groups. There were no significant difference in endocrine(9.1% vs 8.7%)or exocrine(9.1% vs 4.3%)dysfunction after tumor enucleations between the two groups(P>0.05).

Conclusions:LE is a procedure as safe and feasible as OE and could preserve the pancreatic function.

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