Comparision Of Laparoscopic Versus Open Distal Pancreatectomy Treating Benign Diseases Of Pancreas

The location of pancreas is deep and hard to reveal, so that open operation needs large incision and large wound. With elevating of laparoscopic technique and laparoscopic surgical instruments, laparoscopic technique is gradually used in staging of pancreas cancer, palliative surgery of advanced pancreas cancer and drainaging of pancreatic cyst. It is already used in distal pancreatectomy. But the pertinent literatures of Laparoscopic Distal Pancreatectomy (LDP) are mostly case reports, defecting contrast analysis with Open Distal Pancreatectomy (ODP). we analyze the information of operation, post-operation and follow-up to investigate the therapeutic effect of LDP.Methods and MaterialsFrom January 2000 to January 2006, 23 patients(including 11 LDP and 12 ODP) from General Surgery of Sir Run Run Show Hospital with benign deseases who undergone LDP were retrospectively contrasted analyzed. Clinical data contain: 1.general information: age, gender; 2.operation information: operation time, the operation bleeding loss, the length of incision; 3.post-operation information: complication, hospital stays after operation, the time of extubating after operation; 4.follow up: the symptom of post-operation and recurrence.ResultsTwo groups of patients' general materials(age and gender) don't have significance difference (P>0.05). The hospital stays after operation of LDP and ODP were 7.9d±3.3d, 10.8d±4.4d (P<0.05), the time of extubating after operation were 6.1d±3.3d, 8.7d±4.3d (P<0.05), the length of incision were 3.3cm±0.8cm, 16.8cm±4.6cm (P<0.05), the operation time were 212.3min±44.9min, 155.5min±34.6min ( p<0.05 ) , the operation bleeding loss were 327.3ml±285.8ml, 427.3ml±316.52ml (P>0.05); In group LDP, only 1 case had pancreas leak and lung infection happened (9.1%), none need to perform operation again, one needs blood transfusion(9.1 %) after operation; In group ODP, there were 6 cases(50%) with the complication appears after operation, including 1 lung infection, 1 intestinal obstruction , 2 seroperitoneums, 2 pancreas leaks; 2 casesneed to perform operation again, 1 need puncture drainage with BUS guiding for the seroperitoneuma, 2 need blood transfusion (16.7%) after operation. The death has not taken place to two groups. Patients were followed up for 5 months to 31 months in group LDP, 10 months to 70 months in group ODP. Clinical symptom was missed in the two group. There were no recidivation in all patients.ConclusionThe feasibility and safety of LDP had been demonstrated; Compared to ODP, it had the advantages of minimal injury, earlier recovery, less complication and shorter hospital stays.