The Indications for Laparoscopic Pancreatectomy.
Marco Siech1, Peter Strauss, Stephanie Huschitt
1Department of Surgery I, Ostalb Klinikum Aalen; Department of General and Visceral Surgery, Medical Center-University of Freiburg; Department of Visceral, Thoracic and Vascular Surgery University of Marburg; Department of Surgery, University Medical Center-UKSH, Lübeck.
Deutsches Arzteblatt International
|May 5, 2017
Summary
Laparoscopic pancreatectomy shows comparable complication rates to open surgery, with low mortality and mild postoperative pain. Further research via randomized trials is needed to overcome selection bias.
Area of Science:
- Minimally Invasive Surgery
- Gastrointestinal Surgery
- Surgical Oncology
Background:
- Laparoscopic pancreatectomy is not yet a universally established procedure.
- Limited data exists on its short- and long-term outcomes.
Purpose of the Study:
- To gather and analyze data on laparoscopic pancreatectomy procedures.
- To assess the outcomes and complications of laparoscopic pancreatectomy in Germany.
Main Methods:
- A registry was established in 2008, involving 34 centers.
- Data collected on all laparoscopic pancreatectomy cases, including conversions to open surgery.
- Registry contains 550 datasets: 267 benign, 244 malignant, 39 borderline tumors.
Main Results:
- Hemorrhage occurred in 3% of cases; conversion rate to open surgery was 35% (16% excluding minilaparotomies).
- 39% developed pancreatic fistula (1.5% grade C); 3% required reoperation for hemorrhage.
- Procedure-related mortality was 1.3%; 91% reported mild postoperative pain; 6.7% developed new-onset diabetes mellitus.
Conclusions:
- Complication rates are comparable to open surgery, reflecting current German practice.
- The registry data is subject to selection bias.
- Randomized trials are necessary to eliminate selection bias.
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