Effectiveness and feasibility of laparoscopic distal pancreatectomy on patients at high anesthetic risk

Chien Hung Liao, Chun Nan Yeh, Shang Ju Yang, Shang Yu Wang, Chun Hsiang Ouyang, Chun Yi Tsai, Keng Hao Liu, Yu Yin Liu, I. Ming Kuo, Chih Yuan Fu, Ta Sen Yeh*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Background: Laparoscopic distal pancreatectomy (LDP) is the most acceptable procedure in laparoscopic pancreatic surgery. Nevertheless, knowledge regarding patients at a high anesthetic risk during lengthy and technically demanding LDP is controversial. This study aims to assess the feasibility and safety of LDP in patients with high anesthetic risk.

Patients and Methods: We conducted a prospective collection retrospective review of patients underwent LDP and open distal pancreatectomy (ODP) from January 2011 until December 2013. By the American Society of Anesthesiologists score, patients were divided into low- and high-risk patients. We compared the clinical, perioperative, and postoperative results in these patients.

Results: The cohort included 77 patients: 20 underwent LDP, and 57 underwent ODP. There were 30 patients in the low-risk group and 47 patients in the high-risk group. In high-risk patients, LDP, compared with ODP, presented a shorter operating time (mean, 220.8±101.1 minutes versus 299.4±124.3 minutes; P=.038), less blood loss (409.3±569.9mL versus 1083.1±1583.0 mL; P=.039), higher rate of spleen preservation (73.3% versus 43.8%, P=.037), and shorter length of postoperative hospital stay (LOS) (9.5±3.0 days versus 15.7±9.4 days; P=.044).

Conclusions: In conclusion, LDP provides early recovery and better cosmetic appearance. In high anesthetic risk patients, LDP shows less operative time, less perioperative blood loss, a higher rate of spleen preservation, slighter complication, and shorter LOS, which might explain why LDP is a feasible and effective procedure.

Original languageEnglish
Pages (from-to)865-871
Number of pages7
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume24
Issue number12
DOIs
StatePublished - 01 12 2014

Bibliographical note

Publisher Copyright:
© 2014, Mary Ann Liebert, Inc. 2014.

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