LDP vs ODP for pancreatic adenocarcinoma: A retrospectively comparative study

Yi-ping Mou, MD, FACS1, Miao-zun Zhang, MD2, Xiao-wu Xu, MD1, Ren-chao Zhang, MD1, Jia-fei Yan2, Wei-wei Jin1. 1Department of General Surgery, Zhejiang Provincial People’s Hospital, Hangzhou, China, 2Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China

Background:

Laparoscopic distal pancreatectomy (LDP) showed advantage of perioperation outcomes over open distal pancreatectomy (ODP) for benign and low-grade tumor of the pancreas. But LDP for pancreatic ductal adenocarcinoma (PDCA) was not widely accepted. We designed a retrospectively comparative study to analysis the oncological efficacy of Laparoscopic distal pancreatectomy or open distal pancreatectomy for PDCA.

Method:

From 2003.6 to 2015.3, 70 patients consecutively underwent elective LDP or ODP for PDCA. The two groups’ demographic information, perioperative outcomes and survival data were compared.

Results

25 patients underwent LDP with 1 conversion to ODP and 45 patients underwent ODP for PDAC. Baseline characteristics were comparable between the LDP and ODP groups. The intraoperative blood loss, first oral intake and postoperative hospital stay were significantly less in LDP group than ODP group ( 125.2±120.3ml vs 565.1±651.5ml, P=0.000; 3.2±1.1d vs 4.5±1.7d, P=0.006; 12.8±4.4d vs 17.3±8.6d, P=0.005 ). The mean operation time, overall postoperative morbidity and postoperative pancreatic fistula rates were similar in the two groups. There were no significant differences in tumor sizes (3.9+1.0cm vs 3.7+1.0cm, P=0.570) and number of harvested lymph nodes (11.5±7.2 vs 9.7±4.9 P=0.214). The median overall survival for both groups was 14.0 months.

Conclusion

LDP is technically feasible and safe for PDAC in selected patients. The short- and long-term oncologic outcomes were similar between both LDP and ODP for PDAC.

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