Takao Ohtsuka1, Yuichi Nagakawa2, Hirochika Toyama3, Yutaka Takeda4, Atsuyuki Maeda5, Yusuke Kumamoto6, Yoshiharu Nakamura7, Kazuki Hashida8, Goro Honda9, Kengo Fukuzawa10, Eiji Toyoda11, Minoru Tanabe12, Naoto Gotohda13, Ippei Matsumoto14, Tomoki Ryu15, Ichiro Uyama16, Toru Kojima17, Michiaki Unno18, Daisuke Ichikawa19, Yosuke Inoue20, Hiroyoshi Matsukawa21, Takeshi Sudo22, Kyoichi Takaori23, Hiroki Yamaue24, Susumu Eguchi25, Munenori Tahara26, Makoto Shinzeki27, Hidetoshi Eguchi28, Masanao Kurata29, Mamoru Morimoto30, Hiromitsu Hayashi31, Shigeru Marubashi32, Masafumi Inomata33, Kenjiro Kimura34, Koji Amaya35, Masayuki Sho36, Ryuichi Yoshida37, Akihiro Murata38, Hideyuki Yoshitomi39, Kenichi Hakamada40, Masafumi Yasunaga41, Nobutsugu Abe42, Masayoshi Hioki43, Masaru Tsuchiya44, Takeyuki Misawa45, Yasuji Seyama46, Hirokazu Noshiro47, Eiji Sakamoto48, Kiyoshi Hasegawa49, Yasunari Kawabata50, Yoichiro Uchida51, Shinichiro Kameyama52, Saiho Ko53, Takashi Takao54, Kenji Kitahara55, Shin Nakahira56, Hideo Baba57, Masahiko Watanabe58,59, Masakazu Yamamoto60,61, Masafumi Nakamura1,62. 1. Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 2. Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan. 3. Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo, Japan. 4. Department of Surgery, Kansai Rosai Hospital, Amagasaki, Hyogo, Japan. 5. Department of Surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan. 6. Department of General, Pediatric and Hepato-Biliary-Pancreatic Surgery, Kitasato University Hospital, Sagamihara, Kanagawa, Japan. 7. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School, Tokyo, Japan. 8. Department of Surgery, Kurashiki Central Hospital, Kurashiki, Okayama, Japan. 9. Department of Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan. 10. Department of Surgery, Oita Red Cross Hospital, Oita, Japan. 11. Department of Surgery, Otsu Red Cross Hospital, Otsu, Shiga, Japan. 12. Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Tokyo Medical and Dental University, Tokyo, Japan. 13. Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital East, Kashiwa, Chiba, Japan. 14. Department of Surgery, Kindai University Faculty of Medicine, Osaka, Japan. 15. Department of Hepato-Biliary-Pancreatic Surgery, Clinical Research Institute, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan. 16. Department of Surgery, Fujita Health University, Toyoake, Aichi, Japan. 17. Department of Surgery, Okayama Saiseikai General Hospital, Okayama, Japan. 18. Department of Surgery, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan. 19. First Department of Surgery, Faculty of Medicine, University of Yamanashi, Kofu, Yamanashi, Japan. 20. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. 21. Department of Surgery, Hiroshima City Hiroshima Citizens Hospital, Hiroshima, Japan. 22. Department of Surgery National Hospital Organization Kure Medical Center Chugoku Cancer Center, Kure, Hiroshima, Japan. 23. Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan. 24. Second Department of Surgery, School of Medicine, Wakayama Medical University, Wakayama, Japan. 25. Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 26. Department of Surgery, Hokkaido P.W.F.A.C Sapporo Kosei General Hospital, Sapporo, Hokkaido, Japan. 27. Department of Surgery, Osaka Saiseikai Nakatsu Hospital, Osaka, Japan. 28. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan. 29. Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Faculty of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. 30. Department of Gastroenterological Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Aichi, Japan. 31. Department of Surgery, Saiseikai Kumamoto Hospital, Kumamoto, Japan. 32. Department of Hepato-Biliary-Pancreatic and Transplant Surgery, Fukushima Medical University, Fukushima, Japan. 33. Department of Gastroenterological and Pediatric Surgery, Oita University Faculty of Medicine, Yufu, Oita, Japan. 34. Department of Surgical Oncology, Osaka City University School of Medicine, Osaka, Japan. 35. Department of Surgery, Toyama Prefectural Central Hospital, Toyama, Japan. 36. Department of Surgery, Nara Medical University, Kashihara, Nara, Japan. 37. Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan. 38. Department of Hepatobiliary Pancreatic Surgery, Osaka City General Hospital, Osaka, Japan. 39. Department of General Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan. 40. Department of Gastroenterological Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Aomori, Japan. 41. Department of Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan. 42. Department of Surgery, Kyorin University School of Medicine, Mitaka, Tokyo, Japan. 43. Department of Gastroenterological Surgery, Fukuyama City Hospital, Fukuyama, Hiroshima, Japan. 44. Division of General and Gastroenterological Surgery, Department of Surgery, Toho University School of Medicine, Omori, Tokyo, Japan. 45. Department of Surgery, The Jikei University Kashiwa Hospital, Kashiwa, Chiba, Japan. 46. Department of Surgery, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan. 47. Department of Surgery, Faculty of Medicine, Saga University, Saga, Japan. 48. Department of Surgery, Nagoya Daini Red Cross Hospital, Nagoya, Aichi, Japan. 49. Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. 50. Department of Digestive and General Surgery, Shimane University Faculty of Medicine, Izumo, Shimane, Japan. 51. Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan. 52. Department of Surgery, Center for Gastroenterology, Urasoe General Hospital, Urasoe, Okinawa, Japan. 53. Department of Surgery, Nara Prefecture General Medical Center, Nara, Japan. 54. Department of Surgery, Shin Koga Hospital, Kurume, Fukuoka, Japan. 55. Department of Surgery, Saga Medical Center Koseikan, Saga, Japan. 56. Department of Surgery, Sakai City Medical Center, Sakai, Osaka, Japan. 57. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. 58. Kitasato University Kitasato Institutional Hospital, Sagamihara, Kanagawa, Japan. 59. Japan Society for Endoscopic Surgery, Tokyo, Japan. 60. Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Tokyo, Japan. 61. Japanese Society of Hepato-Biliary-Pancreatic Surgery, Tokyo, Japan. 62. Japanese Society for Endoscopic and Robotic Pancreatic Surgery, Tokyo, Japan.
Abstract
BACKGROUND: Prospective studies are needed to understand the safety and feasibility of laparoscopic pancreatectomy. The aim of the present study was to describe laparoscopic pancreatectomy currently undertaken in Japan, using a prospective registration system. METHODS: Patient characteristics and planned operations were registered preoperatively, and then the performed operation and outcomes were reported using an online system. Collected data were also compared between institutions based on their level of experience. This study was registered with UMIN000022836. RESULTS: Available data were obtained from 1,429 patients at 100 Japanese institutions, including 1,197 laparoscopic distal pancreatectomies (LDPs) and 232 laparoscopic pancreatoduodenectomies (LPDs). The rates of completion for planned operations were 92% for LDP and 91% for LPD. Postoperative complication rates after LDP and LPD were 17% and 30%, and 90-day mortality rates were 0.3% and 0.4%, respectively. Shorter operation time, less blood loss, and lower incidence of pancreatic fistula were observed in institutions experienced in LDP. A higher rate of pure laparoscopic procedure and shorter operation time were noted in institutions experienced with LPD. CONCLUSION: LDPs and LPDs are performed safely in Japan, especially in experienced institutions. Our data could support the next challenges in the field of laparoscopic pancreatectomy.
BACKGROUND: Prospective studies are needed to understand the safety and feasibility of laparoscopic pancreatectomy. The aim of the present study was to describe laparoscopic pancreatectomy currently undertaken in Japan, using a prospective registration system. METHODS:Patient characteristics and planned operations were registered preoperatively, and then the performed operation and outcomes were reported using an online system. Collected data were also compared between institutions based on their level of experience. This study was registered with UMIN000022836. RESULTS: Available data were obtained from 1,429 patients at 100 Japanese institutions, including 1,197 laparoscopic distal pancreatectomies (LDPs) and 232 laparoscopic pancreatoduodenectomies (LPDs). The rates of completion for planned operations were 92% for LDP and 91% for LPD. Postoperative complication rates after LDP and LPD were 17% and 30%, and 90-day mortality rates were 0.3% and 0.4%, respectively. Shorter operation time, less blood loss, and lower incidence of pancreatic fistula were observed in institutions experienced in LDP. A higher rate of pure laparoscopic procedure and shorter operation time were noted in institutions experienced with LPD. CONCLUSION: LDPs and LPDs are performed safely in Japan, especially in experienced institutions. Our data could support the next challenges in the field of laparoscopic pancreatectomy.
Authors: Andrew A Gumbs; Elie Chouillard; Mohamed Abu Hilal; Roland Croner; Brice Gayet; Michel Gagner Journal: Surg Endosc Date: 2020-11-04 Impact factor: 4.584