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Medline ® Abstract for Reference 76

of 'Surgical resection of sporadic pancreatic neuroendocrine tumors'

76
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Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications.
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DiNorcia J, Schrope BA, Lee MK, Reavey PL, Rosen SJ, Lee JA, Chabot JA, Allendorf JD
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J Gastrointest Surg. 2010;14(11):1804. Epub 2010 Jun 30.
 
BACKGROUND: Laparoscopic distal pancreatectomy (LDP) is increasingly performed for lesions of the body and tail of the pancreas. The aim of this study was to investigate short-term outcomes after LDP compared to open distal pancreatectomy (ODP) at a single, high-volume institution.
METHODS: We reviewed records of patients who underwent distal pancreatectomy (DP) and compared perioperative data between LDP and ODP. Continuous variables were compared using Student's t or Wilcoxon rank-sum tests. Categorical variables were compared using chi-square or Fisher's exact test.
RESULTS: A total of 360 patients underwent DP. Beginning in 2001, 95 were attempted, and 71 were completed laparoscopically with a 25.3% conversion rate. Compared to ODP, LDP had similar rates of splenic preservation, pancreatic fistula, and mortality. LDP had lower blood loss (150 vs. 900 mL, p<0.01), smaller tumor size (2.5 vs. 3.6 cm, p<0.01), and shorter length of resected pancreas (7.7 vs. 10.0 cm, p<0.01). LDP had fewer complications (28.2% vs. 43.8%, p = 0.02) as well as shorter hospital stays (5 vs. 6 days, p<0.01).
CONCLUSIONS: LDP can be performed safely and effectively in patients with benign or low-grade malignant neoplasms of the distal pancreas. When feasible in selected patients, LDP offers fewer complications and shorter hospital stays.
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Department of Surgery, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
PMID