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Laparoscopic Radical Left Pancreatectomy for Pancreatic Cancer: Surgical Strategy and Technique Video
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Comparing Open and Laparoscopic Left-Sided Pancreatic Resection at a National Level: An IDEAL IV Study on
Kjetil Søreide1,2, Dyre Kleive3, Linn Såve Nymo4,5
1From the Department of Gastrointestinal Surgery, HPB Unit, Stavanger University Hospital, Stavanger, Norway (Søreide).
Journal of the American College of Surgeons
|May 14, 2026
Summary
Minimally invasive surgery (MIS) for left-sided pancreatectomies shows regional variation but is linked to better outcomes. MIS is associated with shorter hospital stays and higher ideal outcome rates, especially in nonobese patients.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Health Services Research
Background:
- Minimally invasive surgery (MIS) for left-sided pancreatectomies is growing, yet clinical practice varies.
- Population-level analysis of MIS implementation can reveal areas for improvement in pancreatic surgery.
Purpose of the Study:
- To investigate the national implementation of minimally invasive left-sided pancreatic resections.
- To analyze population-adjusted resection rates and the impact of MIS on ideal outcomes.
Main Methods:
- Nationwide IDEAL stage IV cohort study (2016-2023) of open and laparoscopic left-sided pancreatectomies from a national quality register.
- Calculation of population-adjusted resection rates over time and ideal outcome rates.
- Risk assessment using odds ratios with 95% confidence intervals (CI).
Main Results:
- Out of 817 procedures, 63.5% were MIS. Resection rates remained stable, but MIS use varied regionally.
- MIS was linked to shorter hospital stays and more discharges to home.
- Patients undergoing MIS were younger, healthier, and achieved higher ideal outcomes, particularly nonobese patients with good performance status.
Conclusions:
- Significant regional differences exist in MIS adoption for left-sided pancreatectomies.
- While MIS is associated with selecting younger, nonobese patients and fewer malignant cases, it doubles the rate of ideal outcomes.
