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The application of minimally invasive pancreatic surgery in cancer : a single institution experience

Yun Liang, MD, Wei Wang. Huadong hospital, Fudan University, Shanghai, China

Background: The use of minimally invasive pancreatic surgery (MIPS) in patients with benign tumor is wildly accepted. Till now whether this approach is also suitable in cancer patients is still a discussion. Our objective is to determine the clinical benefit of MIPS in cancer patients.

Methods: We retrospectively studied all patients underwent MIPS in our institution from May 2010 to January 2017. Demographic and clinical details were retrospectively collected from medical records.

Results: Overall, 70 patients were included in the analysis (16 underwent robotic assisted distal pancreatectomy RADP, 26 underwent laparoscopic distal pancreatectomy LDP, 28 underwent total laparoscopic pancreaticoduodenectomy TLPD). Among 70 patients, 31 were malignant tumors, 23 were borderline malignant tumors, 16 were benign diseases. They had comparable perioperative outcomes. In TLPD group, the mean operation time were 413min (95% CI 374-452), 440min (95% CI 382-498), 441min (95% CI 271-611); the mean blood loss were 262ml (95% CI 175-349), 129ml (95% 83-174), 125ml (95% CI -13-262); the mean length of hospital stay were 15.7 days (95% CI 7.5-24 ), 20.6 days (95% CI -1.7-42.9), 18.5 days (95% CI -4.7-41.7) for malignant, borderline and benign tumors. In RADP and LDP group, the mean operation time were 206min (95% CI 153-258),187min (95% CI 147-226), 175min (95% CI 128-222); the mean blood loss were 196ml(95% CI 75-318), 205ml (95% CI 82-328), 154ml (95% CI 75-234) ; the mean length of hospital stay were 16.0 days (95% CI 10.5-21.5), 13.5days (95% CI 7.2-19.8), 12.3days (95% CI 9.3-15.2) for malignant, borderline and benign tumors. There was no significant difference in postoperative pancreatic fistula (POPF) rate between cancer patients and the others, 14.3% VS 16%. In pancreatic ductal adenocarcinoma(PDAC) patients groups, R1 resection rate was 18%, one year survival rate was 63.3%, two years survival rate was 36.3%, similar to open pancreatic surgery according to the literature.

Conclusion: Based on clinical and oncological outcomes, MIPC is feasibld and safe in pancreatic cancer patients. But there still need further follow-up to study the long-term outcome of MIPC in cancer patients.

 


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 86156

Program Number: P532

Presentation Session: iPoster Session (Non CME)

Presentation Type: Poster

36

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