Comparison of clinical outcomes and QOL between LCP & OCP with PJ

Renchao Zhang¹, Xiaowu Xu¹, Yiping Mou¹, YuCheng Zhou¹, Jiayu Zhou². ¹Department of General Surgery, Zhejiang provincial people’s Hospital,, ²School of Medicine, Zhejiang University

Background:The studies comparing laparoscopic and open central pancreatectomy  with pancreaticojejunostomy are limited. This study aimed to compare clinical outcomes  and quality of life of patients undergoing laparoscopic and open central pancreatectomy with pancreaticojejunostomy.

Methods:Between December 1997 and July 2015, patients who underwent central pancreatectomy with pancreaticojejunostomy were reviewed. Patients were divided into 2 groups as LCP and open central pancreatectomy (OCP). Data considered for comparison analysis were patient demographics, intraoperative variables, morbidity, postoperative hospital stay, mortality, pathologic findings, and quality of life (SF-36 questionnaire).

Results:Thirty-six patients (17 LCP and 19 OCP) were included in the final analysis. Baseline characteristics were similar in the 2 groups. The operating time (280.4±33.6 vs 290.5±62.5min, P=0.455) were similar between two groups. LCP group showed significantly lower estimated blood loss  (76.4±70.3 vs 390.3±279.0ml, P=0.001), shorter first flatus time (2.4±0.9 vs. 3.9±1.3 days, P = 0.001), shorter diet start time(4.1±2.2 vs 6.1±2.4 days, P = 0.030). However, the postoperative hospital stay was not significantly different between two groups (15.6±12.1 vs 24.0±27.5 days, P=0.347). Postoperative outcomes, including morbidity (58.8% vs 52.6%, P=0.735), pancreatic fistula rates(≥grade B:23.5% vs 41.1%, P=0.086) and mortality, were similar in the 2 groups. On the follow-up survey, the total quality of life score(702.9±47.9 vs 671.8±94.1), physical health  score (353.9±24.8 vs 326.6±67.6)and mental health score(349.0±26.5 vs 345.2±34.6) were higher in the LCP group compared with the OCP group. However, these differences were not statistically significant (P>0.05). The score in role-physical(100 vs 73.1±4.8, P=0.042) was significantly higher in LCP group, and not statistically significant in other scales(P>0.05).

Conclusions:LCP with pancreaticojejunostomy is safe and feasible for benign or borderline malignant lesions in the pancreatic neck and proximal body . This series showed a better quality of life for LCP than for OCP