Authors: Marco Braga Nicolò Pecorelli Denise Ferrari Gianpaolo Balzano Walter Zuliani Renato Castoldi
Publish Date: 2014/10/08
Volume: 29, Issue: 7, Pages: 1871-1878
Abstract
Laparoscopic distal pancreatectomy LDP has been recently proposed as the procedure of choice for lesions of the pancreatic body and tail in experienced centres The purpose of this study is to assess the potential advantages of LDP in a consecutive series of 100 patientsPropensity score matching was used to identify patients for comparison between LDP and control open group Match criteria were age gender ASA score BMI lesion site and size and malignancy All patients were treated according to an early feeding recovery policy Primary endpoint was postoperative morbidity rate Secondary endpoints were operative time blood transfusion length of hospital stay LOS hospital costs and quality of lifeThirty patients of the LDP group had pancreatic adenocarcinoma Conversion to open surgery was necessary in 23 patients Mean operative time was 29 min shorter in the open group p = 0002 No significant difference between groups was found in blood transfusion rate and postoperative morbidity rate LDP was associated with an early postoperative rehabilitation and a shorter LOS in uneventful patients Economic analysis showed € 775 extra cost per patient of the LDP group General health perception and vitality were better in the LDP group one month after surgeryLaparoscopic distal pancreatectomy improved shortterm postoperative recovery and quality of life in a consecutive series of both cancer and noncancer patients Despite the extra cost the laparoscopic approach should be considered the first option in patients undergoing distal pancreatectomy
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