Jaivikash Raghupathy1,2, Chuan-Yaw Lee1,2, Sarah K W Huan1, Ye-Xin Koh1,3,4, Ek-Khoon Tan1,3,4, Jin-Yao Teo1,3, Peng-Chung Cheow1,3,4, London L P J Ooi1,3, Alexander Y F Chung1,3,4, Chung-Yip Chan1,3,4, Brian K P Goh5,6,7. 1. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Academia, Level 5, 20 College Road, Singapore, 169856, Singapore. 2. Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore. 3. Duke-NUS Medical School, National University of Singapore, Singapore, Singapore. 4. Singhealth Duke-NUS Transplant Center, Singapore, Singapore. 5. Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Academia, Level 5, 20 College Road, Singapore, 169856, Singapore. bsgkp@hotmail.com. 6. Duke-NUS Medical School, National University of Singapore, Singapore, Singapore. bsgkp@hotmail.com. 7. Singhealth Duke-NUS Transplant Center, Singapore, Singapore. bsgkp@hotmail.com.
Abstract
BACKGROUND: Minimally invasive distal pancreatectomy (MIDP) is being adopted increasingly worldwide. This study aimed to compare the short-term outcomes of patients who underwent MIDP versus open distal pancreatectomy (ODP). METHODS: A retrospective review of all patients who underwent a DP in our institution between 2005 and 2019 was performed. Propensity score matching based on relevant baseline factors was used to match patients in the ODP and MIDP groups in a 1:1 manner. Outcomes reported include operative duration, blood loss, postoperative length of stay, morbidity, mortality, postoperative pancreatic fistula rates, reoperation and readmission. RESULTS: In total, 444 patients were included in this study. Of 122 MIDP patients, 112 (91.8%) could be matched. After matching, the median operating time for MIDP was significantly longer than ODP [260 min (200-346.3) vs 180 (135-232.5), p < 0.001], while postoperative stay for MIDP was significantly shorter [median 6 days (5-8) versus 7 days (6-9), p = 0.015]. There were no significant differences noted in any of the other outcomes measured. Over time, we observed a decrease in the operation times of MIDP performed at our institution. CONCLUSION: Adoption of MIDP offers advantages over ODP in terms of a shorter postoperative hospital stay, without an increase in morbidity and/or mortality but at the expense of a longer operation time.
BACKGROUND: Minimally invasive distal pancreatectomy (MIDP) is being adopted increasingly worldwide. This study aimed to compare the short-term outcomes of patients who underwent MIDP versus open distal pancreatectomy (ODP). METHODS: A retrospective review of all patients who underwent a DP in our institution between 2005 and 2019 was performed. Propensity score matching based on relevant baseline factors was used to match patients in the ODP and MIDP groups in a 1:1 manner. Outcomes reported include operative duration, blood loss, postoperative length of stay, morbidity, mortality, postoperative pancreatic fistula rates, reoperation and readmission. RESULTS: In total, 444 patients were included in this study. Of 122 MIDP patients, 112 (91.8%) could be matched. After matching, the median operating time for MIDP was significantly longer than ODP [260 min (200-346.3) vs 180 (135-232.5), p < 0.001], while postoperative stay for MIDP was significantly shorter [median 6 days (5-8) versus 7 days (6-9), p = 0.015]. There were no significant differences noted in any of the other outcomes measured. Over time, we observed a decrease in the operation times of MIDP performed at our institution. CONCLUSION: Adoption of MIDP offers advantages over ODP in terms of a shorter postoperative hospital stay, without an increase in morbidity and/or mortality but at the expense of a longer operation time.
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