Clinical outcomes for 14 consecutive patients with solid pseudopapillary neoplasms who underwent laparoscopic distal pancreatectomy

Abstract Background and Aims Endoscopic ultrasonography-guided ethanol lavage and Taxol injection (EUS-ELTI) in pancreatic cystic lesions have been recently performed in some medical centers. This study aimed to optimize the patient selection and analyze the outcomes in patients who underwent surgery after EUS-ELTI in pancreatic cystic lesions. Methods Among 310 patients who underwent EUS-ELTI between January 2007 and December 2014, 23 underwent surgery after EUS-ELTI owing to incomplete treatment and/or adverse events. We evaluated the surgical outcomes in patients who underwent surgery after EUS-ELTI. Then, we retrospectively compared the clinical outcomes of the patients who underwent the surgery after EUS-ELTI with those of patients who underwent upfront surgery for left-sided pancreatic lesions without the EUS-ELTI procedure. Results The pathology revealed degenerated cysts in 12 patients, mucinous cyst neoplasms in five patients, neuroendocrine tumors in two patients, and one intraductal papillary mucinous neoplasm (IPMN), one solid pseudopapillary tumor, one pancreatic ductal adenocarcinoma arising from an IPMN, and one hepatoid carcinoma. Twelve patients underwent laparoscopic distal pancreatectomy and five patients underwent open distal pancreatectomy. All six patients who had lesions in the pancreatic head underwent open pancreaticoduodenectomy. When we retrospectively compared the clinical outcomes between patients who underwent laparoscopic distal pancreatectomy after EUS-ELTI and those who did not receive the EUS-ELTI procedure, the spleen-preserving rate was 0% in the EUS-ELTI group and 61.7% (365/592) in the non-EUS-ELTI group (P < 0.001). Clinically relevant postoperative pancreatic fistulas occurred in 33.3% of patients in the EUS-ELTI group and in 6.8% of patients in the non-EUS-ELTI group (P = 0.025). The mean postoperative hospital stay was also shorter in the non-EUS-ELTI group than in the EUS-ELTI group (8.66 ± 5.66 and 13.56 ± 7.20, P = 0.032). Conclusion Surgical outcomes are compromised after EUS-ELTI in the cystic tumor of the pancreas. Further investigations are needed for investigation of the efficacy and safety of the EUS-ELTI procedure.

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Robotic versus laparoscopic distal pancreatectomy: A comparative study of clinical outcomes and costs analysis

International Journal of Surgery ◽

10.1016/j.ijsu.2017.10.075 ◽

2017 ◽

Vol 48 ◽

pp. 300-304 ◽

Cited By ~ 12

Author(s):

Benedetto Ielpo ◽

Hipolito Duran ◽

Eduardo Diaz ◽

Isabel Fabra ◽

Riccardo Caruso ◽

...

Keyword(s):

Comparative Study ◽

Distal Pancreatectomy ◽

Clinical Outcomes ◽

Laparoscopic Distal Pancreatectomy ◽

Costs Analysis

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Comparison of clinical outcomes and quality of life between laparoscopic distal pancreatectomy with or without spleen preservation

Surgical Endoscopy ◽

10.1007/s00464-020-07783-2 ◽

2020 ◽

Author(s):

Ren-Chao Zhang ◽

Jun Ma ◽

Yi-Ping Mou ◽

Jia-Fei Yan ◽

Yu-Cheng Zhou

Keyword(s):

Quality Of Life ◽

Distal Pancreatectomy ◽

Clinical Outcomes ◽

Laparoscopic Distal Pancreatectomy ◽

Spleen Preservation

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PCN192 - ROBOTIC VERSUS LAPAROSCOPIC DISTAL PANCREATECTOMY: A COMPARATIVE STUDY OF CLINICAL OUTCOMES AND COSTS ANALYSIS

Value in Health ◽

10.1016/j.jval.2018.09.274 ◽

2018 ◽

Vol 21 ◽

pp. S46-S47

Author(s):

J. Nuñez Alfonsel ◽

B. Ielpo ◽

Y. Quijano ◽

E. Vicente ◽

A. Hidalgo

Keyword(s):

Comparative Study ◽

Distal Pancreatectomy ◽

Clinical Outcomes ◽

Laparoscopic Distal Pancreatectomy ◽

Costs Analysis

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Comparison of Clinical Outcomes of Single Incision versus Conventional Multi-Port Laparoscopic Distal Pancreatectomy: A Single Institution Experience

SiSli Etfal Hastanesi Tip Bulteni / The Medical Bulletin of Sisli Hospital ◽

10.14744/semb.2019.37880 ◽

2019 ◽

Author(s):

Orhan Agcaoglu

Keyword(s):

Distal Pancreatectomy ◽

Clinical Outcomes ◽

Single Incision ◽

Laparoscopic Distal Pancreatectomy ◽

Single Institution

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P-P44 Clinical outcomes of consecutive patients undergoing distal pancreatectomy over the last decade at a high volume tertiary pancreatic surgery unit

British Journal of Surgery ◽

10.1093/bjs/znab430.266 ◽

2021 ◽

Vol 108 (Supplement_9) ◽

Author(s):

Bhavik Patel ◽

Richard Fristedt ◽

Zaed Hamady ◽

Arjun Takhar ◽

Tom Armstrong ◽

...

Keyword(s):

Distal Pancreatectomy ◽

Clinical Outcomes ◽

Pancreatic Surgery ◽

Laparoscopic Approach ◽

High Volume ◽

Laparoscopic Distal Pancreatectomy ◽

Pancreatic Stump ◽

Stump Closure ◽

Significant Difference ◽

Surgical Data

Abstract Background Distal pancreatectomy (DP) enables resection of lesions in the body and tail of the pancreas. Over the past decade, the Laparoscopic approach has become frequently employed. There remains scarce outcome data available following laparoscopic distal pancreatectomy over a long time period from high volume centres. Postoperative pancreatic fistula (POPF) remains the main source of morbidity and mortality after DP. The causes of POPF are multifactorial and poorly understood. The optimal method of pancreatic stump closure is still debated with variation in clinical practice. Methods All patients that underwent distal pancreatectomy at a UK tertiary pancreatic surgery centre between January 2011 and January 2021 were identified and clinical outcomes examined. Patients undergoing completion pancreatectomies were excluded. Clinical, pathological and surgical data for the included patients was retrospectively collected from the electronic patient record. Clinically significant POPF was defined as Grade B or C as per the ISGPF guidelines. For stapled stump closure, the Compression Index (CI) was calculated using closed staple height (mm) divided by the pancreatic thickness (mm). High and low CI was defined around the median. Results 233 patients (n = 90 open and n = 143 laparoscopic) were included in the final analysis. The laparoscopic approach was associated with comparable morbidity and significantly lower blood loss, shorter operative time and shorter length of stay. There were no significant differences in age, sex, final histology, closure technique, or ASA Score of 3 or more amongst patients with clinically relevant POPF (CR-POPF). The POPF group had a significantly higher BMI, drain duration and readmission rate. CI data was available for 78 cases (range 0.04-0.21). There was no significant difference in low vs high CI for patients with CR-POPF. Conclusions Laparoscopic distal pancreatectomy is associated with favourable clinical outcomes in this series. Stapled vs sutured closure of the pancreatic stump offered equivocal outcomes with relation to POPF. POPF continues to have a significant impact on a clinical recovery as evident from longer drain duration and high readmission rates. Further research is required to try to establish methods for reducing the incidence of POPF after distal pancreatectomy.

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