Riccardo Casadei1,2, Claudio Ricci3, Carlo Alberto Pacilio3, Carlo Ingaldi3, Giovanni Taffurelli3, Francesco Minni3. 1. Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy. riccardo.casadei@unibo.it. 2. Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Chirurgia Generale-Prof. Minni, Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Via Massarenti n.9, 40138, Bologna, Italy. riccardo.casadei@unibo.it. 3. Dipartimento di Scienze Mediche e Chirurgiche (DIMEC), Alma Mater Studiorum, Università di Bologna, Policlinico S.Orsola-Malpighi, Bologna, Italy.
Abstract
BACKGROUND: Laparoscopic distal pancreatectomy represents a difficult surgical procedure with an high conversion rate to open procedure. The factors related to its difficulty and conversion to open distal pancreatectomy were rarely reported. The aim of the present study was to identify which factors are related to conversion from laparoscopic to open distal pancreatectomy. METHODS: A retrospective study of a prospective database of 68 patients who underwent laparoscopic distal pancreatectomy was conducted at a high-volume center by pancreatic surgeons experienced with laparoscopic surgery. Pre-intra and postoperative data were collected. Patients who completed a laparoscopic distal pancreatectomy were compared with those who needed a conversion to the open approach as regard demographic, clinical, radiological, and surgical data. Univariate and multivariate analyses were carried out. RESULTS: Univariate analysis suggested that the site of the lesion, the extension of pancreatic resection, and the requirement for an extended procedure to adjacent organs were significantly associated with the risk of conversion to the open approach. Multivariate analysis showed that only the extension of the pancreatic resection (subtotal pancreatectomy) was significantly related to the odds of conversion [odds ratio (OR) 19.5; 95% confidence interval (CI) 1.1-32.3; P = 0.038]. Preoperative suspicion of malignancy differed between the two groups; however, this difference did not reach statistical significance (P = 0.078). CONCLUSIONS: Despite the limitations of the study, only the extension of pancreatic resection seemed to be the main factor related to conversion during laparoscopic distal pancreatectomy.
BACKGROUND: Laparoscopic distal pancreatectomy represents a difficult surgical procedure with an high conversion rate to open procedure. The factors related to its difficulty and conversion to open distal pancreatectomy were rarely reported. The aim of the present study was to identify which factors are related to conversion from laparoscopic to open distal pancreatectomy. METHODS: A retrospective study of a prospective database of 68 patients who underwent laparoscopic distal pancreatectomy was conducted at a high-volume center by pancreatic surgeons experienced with laparoscopic surgery. Pre-intra and postoperative data were collected. Patients who completed a laparoscopic distal pancreatectomy were compared with those who needed a conversion to the open approach as regard demographic, clinical, radiological, and surgical data. Univariate and multivariate analyses were carried out. RESULTS: Univariate analysis suggested that the site of the lesion, the extension of pancreatic resection, and the requirement for an extended procedure to adjacent organs were significantly associated with the risk of conversion to the open approach. Multivariate analysis showed that only the extension of the pancreatic resection (subtotal pancreatectomy) was significantly related to the odds of conversion [odds ratio (OR) 19.5; 95% confidence interval (CI) 1.1-32.3; P = 0.038]. Preoperative suspicion of malignancy differed between the two groups; however, this difference did not reach statistical significance (P = 0.078). CONCLUSIONS: Despite the limitations of the study, only the extension of pancreatic resection seemed to be the main factor related to conversion during laparoscopic distal pancreatectomy.
Authors: Raghunandan Venkat; Barish H Edil; Richard D Schulick; Anne O Lidor; Martin A Makary; Christopher L Wolfgang Journal: Ann Surg Date: 2012-06 Impact factor: 12.969
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Authors: Claudio Ricci; Riccardo Casadei; Enrico Lazzarini; Marielda D'Ambra; Salvatore Buscemi; Carlo Alberto Pacilio; Giovanni Taffurelli; Francesco Minni Journal: Hepatobiliary Pancreat Dis Int Date: 2014-10
Authors: Deniece Riviere; Kurinchi Selvan Gurusamy; David A Kooby; Charles M Vollmer; Marc G H Besselink; Brian R Davidson; Cornelis J H M van Laarhoven Journal: Cochrane Database Syst Rev Date: 2016-04-04
Authors: A Balduzzi; N van der Heijde; A Alseidi; S Dokmak; M L Kendrick; P M Polanco; D E Sandford; S V Shrikhande; C M Vollmer; S E Wang; H J Zeh; M Abu Hilal; H J Asbun; M G Besselink Journal: Langenbecks Arch Surg Date: 2020-12-10 Impact factor: 3.445
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Authors: Riccardo Casadei; Claudio Ricci; Carlo Ingaldi; Laura Alberici; Maria Chiara Vaccaro; Elisa Galasso; Francesco Minni Journal: World J Surg Date: 2020-10-15 Impact factor: 3.352
Authors: Riccardo Casadei; Carlo Ingaldi; Claudio Ricci; Laura Alberici; Emilio De Raffele; Maria Chiara Vaccaro; Francesco Minni Journal: Updates Surg Date: 2021-04-03