Laparoscopic versus open distal pancreatectomy—a propensity score-matched analysis from the German StuDoQ|Pancreas registry

Purpose The aim of this study was to assess intraoperative, postoperative, and oncologic outcome in patients undergoing laparoscopic distal pancreatectomy (LDP) versus open distal pancreatectomy (ODP) for benign and malignant lesions of the pancreas. Methods Data from patients undergoing distal panc...

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Bibliographic Details
Published in:International journal of colorectal disease 2017-02, Vol.32 (2), p.273-280
Main Authors: Wellner, Ulrich Friedrich, Lapshyn, Hryhoriy, Bartsch, Detlef K., Mintziras, Ioannis, Hopt, Ulrich Theodor, Wittel, Uwe, Krämling, Hans-Jörg, Preissinger-Heinzel, Hubert, Anthuber, Matthias, Geissler, Bernd, Köninger, Jörg, Feilhauer, Katharina, Hommann, Merten, Peter, Luisa, Nüssler, Natascha C., Klier, Thomas, Mansmann, Ulrich, Keck, Tobias
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Comorbidity
Comparative analysis
Female
Gastroenterology
Germany
Health aspects
Hepatology
Humans
Internal Medicine
Laparoscopic surgery
Laparoscopy
Male
Medicine
Medicine & Public Health
Middle Aged
Original Article
Pancreatectomy
Pancreatic cancer
Pancreatic Neoplasms - surgery
Perioperative Care
Proctology
Propensity Score
Registries
Surgery
Treatment Outcome
Young Adult
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Summary:Purpose The aim of this study was to assess intraoperative, postoperative, and oncologic outcome in patients undergoing laparoscopic distal pancreatectomy (LDP) versus open distal pancreatectomy (ODP) for benign and malignant lesions of the pancreas. Methods Data from patients undergoing distal pancreatic resection were extracted from the StuDoQ|Pancreas registry of the German Society for General and Visceral Surgery. After propensity score case matching, groups of LDP and ODP were compared regarding demography, comorbidities, operative details, histopathology, and perioperative outcome. Results At the time of data extraction, the StuDoQ|Pancreas registry included over 3000 pancreatic resections from over 50 surgical departments in Germany. Data from 353 patients undergoing ODP ( n  = 254) or LDP ( n  = 99) from September 2013 to February 2016 at 29 institutions were included in the analysis. Baseline data showed a strong selection bias in LDP patients, which disappeared after 1:1 propensity score matching. A comparison of the matched groups disclosed a significantly longer operation time, higher rate of spleen preservation, more grade A pancreatic fistula, shorter hospital stay, and increased readmissions for LDP. In the small group of patients operated for pancreatic cancer, a lower lymph node yield with a lower lymph node ratio was apparent in LDP. Conclusions LDP needed more time but potential advantages include increased spleen preservation and shorter hospital stay, as well as a trend for less transfusion, ventilation, and mortality. LDP for pancreatic cancer was performed rarely and will need critical evaluation in the future. Data from a prospective randomized registry trial is needed to confirm these results.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-016-2693-4