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Safety and Feasibility of Single-incision Laparoscopic Distal Pancreatectomy

医学 远端胰腺切除术 失血 胰瘘 外科 脾切除术 腹腔镜检查 普通外科 胰腺切除术 胰腺 切除术 内科学 脾脏
作者
Toshihide Sasaki,Ching‐Yao Yang,Kenji Nakagawa,Minako Nagai,Satoshi Nishiwada,Taichi Terai,Masayuki Sho
出处
期刊:Surgical laparoscopy, endoscopy & percutaneous techniques [Ovid Technologies (Wolters Kluwer)]
卷期号:32 (4): 488-493
标识
DOI:10.1097/sle.0000000000001064
摘要

Comparative studies regarding single-incision laparoscopic distal pancreatectomy (SILS-DP) are limited. This study aimed to compare the short-term outcomes of SILS-DP with conventional laparoscopic DP (C-LDP) under strict indication criteria.We retrospectively reviewed the patient characteristics and surgical outcomes of those who underwent either SILS-DP or C-LDP at National Taiwan University (NTU) and C-LDP at Nara Medical University (NMU) between 2009 and 2019. SILS-DP was indicated for benign or low-grade malignant pancreatic tail tumors and was performed along with splenectomy.We compared 12 cases of SILS-DP with 31 of C-LDP from NTU and 17 of C-LDP from NMU. Patients in the SILS-DP group had significantly less blood loss than the C-LDP group at NTU ( P =0.028). Postoperative outcomes, including the postoperative hospital stay and clinically relevant pancreatic fistula, were not significantly different between the 2 groups. Although SILS-DP was performed by a surgeon who was well-experienced with laparoscopic surgeries, the first few cases had a larger amount of blood loss, longer operation time, and a higher rate of complications. Such unfavorable outcomes were likely to be resolved shortly. No reoperations and deaths were noted.SILS-DP is feasible when performed by an experienced surgeon and in carefully selected patients.
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