The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes

Am J Surg. 2015 Mar;209(3):557-63. doi: 10.1016/j.amjsurg.2014.11.001. Epub 2014 Dec 17.

Abstract

Background: The oncologic equivalence of laparoscopic distal pancreatectomy (LDP) to open pancreatectomy (ODP) for ductal adenocarcinoma (DAC) is not established.

Methods: The National Cancer Data Base was used to compare perioperative outcomes following LDP and ODP for DAC between 2010 and 2011.

Results: One hundred forty-five patients underwent LDP; 625 underwent ODP. Compared with ODP, patients undergoing LDP were older (68 ± 10.1 vs 66 ± 10.5 years, P = .027), more likely treated in academic centers (70% vs 59%, P = .01), and had shorter hospital stays (6.8 ± 4.6 vs 8.9 ± 7.5 days, P < .001). Demographic data, lymph node count, 30-day unplanned readmission, and 30-day mortality were identical between groups. Multivariable regression identified a lower probability of prolonged length of stay with LDP (odds ratio .51, 95% confidence interval .327 to .785, P = .0023). There was no association between surgical approach and node count, readmission, or mortality.

Conclusion: LDP for DAC provides shorter postoperative lengths of stay and rates of readmission and 30-day mortality similar to OPD without compromising perioperative oncologic outcomes.

Keywords: Adenocarcinoma; Distal; Laparoscopy; Open; Pancreatectomy.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Carcinoma, Pancreatic Ductal / diagnosis
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Illinois / epidemiology
  • Laparoscopy / methods*
  • Length of Stay / trends*
  • Male
  • Middle Aged
  • Pancreatectomy / methods*
  • Pancreatic Neoplasms / diagnosis
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery*
  • Postoperative Period
  • Retrospective Studies
  • Survival Rate / trends
  • Treatment Outcome