Initial experience with hand-assisted laparoscopic distal pancreatectomy Journal Article
| Authors: | D'Angelica, M.; Are, C.; Jarnagin, W.; DeGregoris, G.; Coit, D.; Jaques, D.; Brennan, M.; Fong, Y. |
| Article Title: | Initial experience with hand-assisted laparoscopic distal pancreatectomy |
| Abstract: | Background: Hand-assisted laparoscopic distal pancreatectomy, with or without splenectomy, is gradually gaining acceptance, although its ultimate benefit is yet to be confirmed. This study aimed to report our initial experience with hand-assisted laparoscopic distal pancreatectomy. Methods: A retrospective review of a prospectively collected database including 17 patients during the period 2002-2004 was conducted. The median age was 60 years (range, 29-85 years), and the female-to-male ratio was 13:4. The preoperative diagnoses included benign and malignant conditions. Besides two to three ports, a hand port was placed in the upper midline to aid in dissection. The pancreas was divided with a stapler in all the patients, and drains were placed in 10 patients (70%). Results: One patient was found to be unresectable because of celiac artery involvement, and 2 of the remaining 16 patients underwent conversion to an open procedure. The median operating time was 196 min (range, 128-235 min). The mean tumor size was 4 cm (range, 2-7 cm), and the estimated blood loss was 125 ml (range, 50-1,250 ml). The median time to resumption of a regular diet was 3.5 days (range, 2-9 days), and the time to conversion to oral pain medications was 3 days (range, 2-9 days). The length of hospital stay was 5.5 days (range, 4-18 days), with a majority of the patients (11 patients, 78%) staying less than 7 days. There were no mortalities. The overall postoperative morbidity rate was 25%, and the morbidities consisted of pancreatic leak/fistula (2 patients, 14%) and fever (1 patient). The margins were negative in 10 (76%) of the relevant 13 patients. At a median follow-up period of 3.8 months (range, 5-14 months), 11 (84%) of 13 patients had no evidence of disease recurrence. Conclusion: The minimally invasive approach to pancreatic disease is safe and technically feasible. Further large studies with longer follow-up periods are necessary to determine the role of laparoscopic surgery in the management of pancreatic disease. © Springer Science+Business Media, Inc. 2005. |
| Keywords: | adult; clinical article; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; surgical technique; retrospective studies; histopathology; postoperative period; pancreas resection; follow up; follow-up studies; laparoscopy; laparoscopic surgery; tumor volume; morbidity; recurrence; time factors; hospitalization; intraoperative period; tumor recurrence; pancreas tumor; operation duration; pancreatectomy; surgical procedures, minimally invasive; postoperative hemorrhage; databases, factual; minimally invasive; pancreatic diseases; hand-assisted; laparoscopic distal pancreatectomy; pancreatic disease |
| Journal Title: | Surgical Endoscopy |
| Volume: | 20 |
| Issue: | 1 |
| ISSN: | 0930-2794 |
| Publisher: | Springer |
| Date Published: | 2006-01-01 |
| Start Page: | 142 |
| End Page: | 148 |
| Language: | English |
| DOI: | 10.1007/s00464-005-0209-3 |
| PUBMED: | 16333550 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 20" - "Export Date: 4 June 2012" - "CODEN: SUREE" - "Source: Scopus" |
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