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Advantage of Postoperative Inflammatory Status after Laparoscopic Distal Pancreatectomy

Saori Funakoshi1,2, Yutaka Suzuki1,2, Masao Yoshida3

  • 1Department of Hepato-Biliary-Pancreatic Surgery, Kyorin University Hospital, Tokyo, Japan.

Digestive Surgery
|October 9, 2024
PubMed
Abstract

Insights

Laparoscopic distal pancreatectomy (LDP) shows fewer complications and faster recovery than open distal pancreatectomy (ODP). The CRP/albumin ratio (CAR) may predict postoperative pancreatic fistula (POPF).

Area of Science:

  • Surgical Oncology
  • Minimally Invasive Surgery
  • Gastrointestinal Surgery

Background:

  • Laparoscopic distal pancreatectomy (LDP) is established, but its inflammatory impact versus open distal pancreatectomy (ODP) is unclear.
  • Assessing short-term outcomes and inflammatory markers after LDP and ODP is crucial for surgical decision-making.

Purpose of the Study:

  • To compare perioperative inflammatory reactions between LDP and ODP.
  • To evaluate the incidence of postoperative pancreatic fistula (POPF) and surgical morbidity.
  • To identify predictors of POPF.

Main Methods:

  • Retrospective analysis of 77 patients undergoing distal pancreatectomy for low-grade malignancies.
  • Comparison of white blood cell count, C-reactive protein (CRP), serum albumin, and CRP/albumin ratio (CAR) between LDP and ODP groups.
  • Evaluation of complications (POPF), recovery, and hospital stay.

Main Results:

  • LDP demonstrated significantly lower POPF (17.1% vs. 38.7%) and surgical morbidity (12.2% vs. 32.3%) compared to ODP.
  • Postoperative inflammatory responses (CRP, CAR) showed only temporary differences between the groups.
  • Elevated CAR (≥6.94) on postoperative day 3 was a significant predictor of POPF (OR 4.828).

Conclusions:

  • LDP is associated with reduced POPF and accelerated postoperative recovery.
  • The CRP/albumin ratio (CAR) shows potential as a predictive marker for POPF after distal pancreatectomy.
Keywords:
Inflammatory responseLaparoscopyPancreatectomy

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