Surgical outcomes of open and laparoscopic left sided pancreatectomy: The 6-year ramathibodi experience

Abstract

© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND| 2019. Objective: Laparoscopic distal pancreatectomy (LDP) has been introduced in Ramathibodi Hospital since 2010 and continuously performed up to the present time. Nevertheless, there were no data or study for LDP in Thailand. The aim of this study was to compare surgical outcomes of LDP with open distal pancreatectomy (ODP) in the past 6-year Ramathibodi Hospital experience. Materials and Methods: In this retrospective study, 49 patients who underwent left sided pancreatectomy at Ramathibodi Hospital from January 2012 to May 2018 were recruited. The patients were classified into 2 groups, open and laparoscopy. The clinicopathological data, intraoperative and postoperative outcomes were collected. Results: In 49 patients, 26 (53.1%) patients were classified into open group and 23 (46.9%) patients into laparoscopic group. There was no mortality in any patients. The conversion rate was 8%. There were 2 (4%) patients with pancreatic ductal adenocarcinoma (PDAC) and 25 (51%) patients of pancreatic cystic tumor. The overall complication was 61.5% in open group and 65.2% in laparoscopy (p = 0.632). The post-operative pancreatic fistula (POPF) was 50.0% in open group and 47.8% in laparoscopy (p = 0.879) as well as in POPF-required intervention which was 7.7% in open group and 13.0% in laparoscopy (p = 0.264). The mean blood loss was 598.0 mL in open group and 302.7 mL in laparoscopy (p = 0.050). Whereas the mean operative time was 252.3 minutes in open group and 255.0 minutes in laparoscopy (p = 0.920) and the mean length of hospital stay was 15.6 days in open group and 11.8 days in laparoscopy (p = 0.302). Conclusion: Left-sided pancreatectomy in Ramathibodi Hospital was a safe and effective procedure but still having a high rate of complication. LDP and ODP were not found different in terms of complication, operative time and POPF.