Comparison Of Laparoscopic Distal Pancreatectomy And Open Distal Pancreatectomy

At present, laparoscopic distal pancreatectomy has become a kind of pancreatic operations which have been performed popularly. There have been many international reports about the comparison of laparoscopic distal pancreatectomy and open distal pancreatectomy, but related domestic studies are fare.Research Objectives:Clinical information of66patients with lesions in pancreatic body or tail consecutive and nonrandom underwent LDP or ODP in Qilu hospital was collected. The general characters and operative outcomes of LDP and ODP were compared to discuss and evaluate the feasibility, safety and advantages of LDP.Methods:The clinical data of66patients undergoing LDP (29cases) or ODP (37cases) admitted from Dec.2005to Dec.2013in General Surgery of Qilu hospital were retrospectively analyzed. We collected and recorded the general information of patients, operation associated data and postoperative recovery associated data, and performed comparative analysis.Results:The total of66available patients who were no-randomized divided into two groups, LDP group with29cases and ODP group with37cases. There are no significant statistical differences between LDP groups and ODP groups in gender, age, weight, abdominal surgery history, chronic disease history, tumor number and diameter, and the pathological diagnosis. LDP groups had a less blood loss (LDP100ml, ODP150ml, P<0.05), shorter scar (LDP3cm, ODP20cm, P<0.01), less postoperative pain-killers (LDP5/29, ODP15/37, P<0.05), shorter time for first flatus (LDP2.90±0.82d, ODP4.03±1.92d, P<0.05), shorter time of fast time (LDP4.93±1.33d, ODP6.54±3.83d, P<0.05) and shorter postoperative stay time (LDP (3.57±0.58)2d, ODP (4.03±0.97)2d, P<0.05). And there are no significant differences between the two groups in the total complication rate (LDP11/29, ODP15/37P=0.830), postoperative pancreatic fistula rate (LDP8/29, ODP14/37P=0.381) and symptomatic postoperative pancreatic fistula rate (LDP1/29, ODP7/37P=0.059). There are no significant differences between the two groups in operative time (LDP216.21±84.95min, ODP225.68±91.80min, P=0.669) and expenditure (LDP41158.19±14115.41Yuan, ODP37519.51±22684.10Yuan, P=0.491).Conclusion:LDP has shown oncologic equivalency to the ODP without increasing the rate of postoperative complications, and has the known benefits of a less blood loss, shorter scar, less postoperative pain-killers, faster postoperative recovery, and no longer operative time and more cost. Above all, LDP is a feasible, safe, efficient and minimal invasive procedure used in patients with lesions in pancreatic body or tail.