Laparoscopic pancreatic resection: Results of a multicenter European study of 127 patients
| Autor: | Laureano Fernández-Cruz, Jean-Michel Fabre, Jean Boulez, Juan Santiago Azagra, Claudio Bassi, Jacques Baulieux, Georges Delvaux, Joseph Weerts, Jean-Louis Peix, Jean-François Gigot, Jean-Yves Mabrut |
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| Rok vydání: | 2005 |
| Předmět: |
Reoperation
medicine.medical_specialty Pancreatic disease medicine.medical_treatment Pancreatectomy medicine Humans Cystadenocarcinoma Insulinoma Mucinous cystadenoma Retrospective Studies business.industry Length of Stay medicine.disease Surgery Pancreatic Neoplasms Treatment Outcome medicine.anatomical_structure Pancreatic fistula Pancreatitis Laparoscopy Neoplasm Recurrence Local Pancreas business Follow-Up Studies |
| Zdroj: | Surgery. 137:597-605 |
| ISSN: | 0039-6060 |
| Popis: | The reported experience with laparoscopic pancreatic resections (LPR) remains limited to case reports or small series of patients.A retrospective multicenter study was conducted in 25 European surgical centers concerning their experience with LPR. Detailed questionnaires were used, focusing on patients, tumors, operative data, and late outcome.During the study period, 127 patients with presumed pancreatic neoplasms were enrolled in this series. Final diagnoses included benign pancreatic diseases in 111 patients (87%; insulinoma: 22, neuroendocrine neoplasm: 20, mucinous cystadenoma: 26, serous cystadenoma: 21, chronic pancreatitis: 11, others: 11), and 16 patients (13%) had malignant pancreatic diseases (insulinoma: 3, neuroendocrine neoplasm: 5, ductal adenocarcinoma: 4, cystadenocarcinoma: 2, renal metastases: 2). Five patients with presumed benign pancreatic disease had malignancy at final pathology. The median tumor size was 30 mm (range, 5-120 mm); 89% of tumors were located in the left pancreas. Laparoscopically successful procedures included 21 enucleations, 24 distal splenopancreatectomies, 58 distal pancreatectomies with splenic preservation, and 3 pancreatoduodenal resections. The overall conversion rate was 14%. There were no postoperative deaths. The rate of overall postoperative pancreatic-related complications was 31%, including a 17% rate of clinical pancreatic fistula. The surgical reoperation rate was 6.3%. In laparoscopically successful operations, the median postoperative hospital stay was 7 days (range, 3-67 days), decreased compared with patients requiring conversion to open pancreatectomy. During a median follow-up of 15 months (range, 3-47 months), 23% of the patients with pancreatic malignancies had tumor recurrence. Late outcome was satisfactory in all patients with benign diseases.LPR is feasible and safe in selected patients with presumed benign and distal pancreatic tumors. The management of the pancreatic stump remains a challenge. The role of LPR for pancreatic malignancies remains controversial. |
| Databáze: | OpenAIRE |
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