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Laparoscopic distal pancreatectomy: better than open?
Abe Fingerhut1, Selman Uranues1, Igor Khatkov2
1Section for Surgical Research, Department of Surgery, University of Graz, Graz, Austria.
Translational Gastroenterology and Hepatology
|September 19, 2018
Summary
Laparoscopic distal pancreatectomy (LDP) is a safe and feasible approach for various pancreatic diseases, offering comparable outcomes to open surgery. Minimal access surgery provides recovery advantages, making LDP the preferred method once surgical expertise is established.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastroenterology
Background:
- Distal pancreatectomy is frequently performed for diseases of the pancreatic body and tail.
- Traditional open distal pancreatectomy (ODP) has established safety and efficacy.
- Concerns exist regarding the safety, oncological outcomes, and applicability of laparoscopic distal pancreatectomy (LDP).
Purpose of the Study:
- To review the literature and assess the safety, oncological outcomes, and applicability of LDP compared to ODP.
- To evaluate LDP's suitability for diverse pancreatic pathologies and patient populations.
- To analyze the cost-effectiveness of LDP versus ODP.
Main Methods:
- Comprehensive literature review of studies comparing LDP and ODP.
- Analysis of safety data, including intra-operative events and post-operative complications.
- Evaluation of oncological outcomes, particularly for malignant conditions.
- Assessment of applicability across different diseases and patient demographics (obese, elderly, frail).
Main Results:
- LDP is feasible and safe for a broad spectrum of benign and malignant pancreatic diseases.
- Morbidity, mortality, and oncological outcomes of LDP are comparable to ODP.
- LDP is adaptable to various patient characteristics and pancreatic conditions.
- Overall costs are similar, but LDP offers advantages in recovery.
Conclusions:
- Laparoscopic distal pancreatectomy is a safe and effective alternative to open surgery.
- LDP provides comparable oncological results and patient recovery benefits.
- The minimal access approach is preferred for distal pancreatectomy once surgical expertise is attained.
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