Skip to main content
Erschienen in: Langenbeck's Archives of Surgery 8/2013

01.12.2013 | Original Article

Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study

verfasst von: Sven-Petter Haugvik, Bård Ingvald Røsok, Anne Waage, Øystein Mathisen, Bjørn Edwin

Erschienen in: Langenbeck's Archives of Surgery | Ausgabe 8/2013

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Laparoscopic distal pancreatectomy is becoming increasingly established at specialized surgical institutions worldwide. The purpose of this study was to compare single-incision laparoscopic distal pancreatectomy (panLESS) with conventional laparoscopic distal pancreatectomy (panLAP) to assess feasibility and 30-day morbidity.

Methods

Eight consecutive patients who underwent panLESS were matched with patients who underwent panLAP in the same time period. Matching criteria were age, body mass index, and American Society of Anesthesiologists score. Feasibility was based on tumor size, operative time, intraoperative bleeding, resection status, and hospital stay. Thirty-day morbidity was defined by the revised Accordion Classification system and the International Study Group on Pancreatic Fistula definition.

Results

Over a 19-month period, 8 and 16 patients were identified for panLESS and panLAP, respectively. There were no significant differences in tumor size, operative time, intraoperative bleeding, resection status, and hospital stay between the two groups. Surgical complications developed in four panLESS patients and five panLAP patients, and out of which, two patients from each group developed a postoperative pancreatic fistula (grade B).

Conclusions

This study indicates that panLESS is comparable to panLAP in terms of feasibility. More experience is needed to define what role single-incision distal pancreatectomy should have in minimal invasive pancreatic surgery.
Literatur
1.
Zurück zum Zitat Fernandez-Cruz L, Cosa R, Blanco L et al (2007) Curative laparoscopic resection for pancreatic neoplasms: a critical analysis from a single institution. J Gastrointest Surg 11(12):1607–1621PubMedCrossRef Fernandez-Cruz L, Cosa R, Blanco L et al (2007) Curative laparoscopic resection for pancreatic neoplasms: a critical analysis from a single institution. J Gastrointest Surg 11(12):1607–1621PubMedCrossRef
2.
Zurück zum Zitat Kooby DA, Gillespie T, Bentrem D et al (2008) Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg 248(3):438–446PubMed Kooby DA, Gillespie T, Bentrem D et al (2008) Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg 248(3):438–446PubMed
3.
Zurück zum Zitat Mabrut JY, Fernandez-Cruz L, Azagra JS et al (2005) Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery 137(6):597–605PubMedCrossRef Mabrut JY, Fernandez-Cruz L, Azagra JS et al (2005) Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery 137(6):597–605PubMedCrossRef
4.
Zurück zum Zitat Eom BW, Jang JY, Lee SE et al (2008) Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc 22(5):1334–1338PubMedCrossRef Eom BW, Jang JY, Lee SE et al (2008) Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc 22(5):1334–1338PubMedCrossRef
5.
Zurück zum Zitat Rosok BI, Marangos IP, Kazaryan AM et al (2010) Single-centre experience of laparoscopic pancreatic surgery. Br J Surg 97(6):902–909PubMedCrossRef Rosok BI, Marangos IP, Kazaryan AM et al (2010) Single-centre experience of laparoscopic pancreatic surgery. Br J Surg 97(6):902–909PubMedCrossRef
6.
Zurück zum Zitat Kneuertz PJ, Patel SH, Chu CK et al (2012) Laparoscopic distal pancreatectomy: trends and lessons learned through an 11-year experience. J Am Coll Surg 215(2):167–176PubMedCrossRef Kneuertz PJ, Patel SH, Chu CK et al (2012) Laparoscopic distal pancreatectomy: trends and lessons learned through an 11-year experience. J Am Coll Surg 215(2):167–176PubMedCrossRef
7.
Zurück zum Zitat Abu HM, Hamdan M, Di FF et al (2012) Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study. Surg Endosc 26(6):1670–1674CrossRef Abu HM, Hamdan M, Di FF et al (2012) Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study. Surg Endosc 26(6):1670–1674CrossRef
8.
Zurück zum Zitat Fox AM, Pitzul K, Bhojani F et al (2012) Comparison of outcomes and costs between laparoscopic distal pancreatectomy and open resection at a single center. Surg Endosc 26(5):1220–1230PubMedCrossRef Fox AM, Pitzul K, Bhojani F et al (2012) Comparison of outcomes and costs between laparoscopic distal pancreatectomy and open resection at a single center. Surg Endosc 26(5):1220–1230PubMedCrossRef
9.
Zurück zum Zitat Butturini G, Inama M, Malleo G et al (2012) Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: a retrospective analysis. J Surg Oncol 105(4):387–392PubMedCrossRef Butturini G, Inama M, Malleo G et al (2012) Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: a retrospective analysis. J Surg Oncol 105(4):387–392PubMedCrossRef
10.
Zurück zum Zitat Chang SK, Lomanto D, Mayasari M (2012) Single-port laparoscopic spleen preserving distal pancreatectomy. Minim Invasive Surg 2012:197429PubMed Chang SK, Lomanto D, Mayasari M (2012) Single-port laparoscopic spleen preserving distal pancreatectomy. Minim Invasive Surg 2012:197429PubMed
11.
Zurück zum Zitat Kuroki T, Adachi T, Okamoto T et al (2011) Single-incision laparoscopic distal pancreatectomy. Hepatogastroenterology 58(107–108):1022–1024PubMed Kuroki T, Adachi T, Okamoto T et al (2011) Single-incision laparoscopic distal pancreatectomy. Hepatogastroenterology 58(107–108):1022–1024PubMed
12.
Zurück zum Zitat Matthes K, Thakkar SJ, Lee SH et al (2011) Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation. Surg Endosc 25(10):3191–3197PubMedCrossRef Matthes K, Thakkar SJ, Lee SH et al (2011) Development of a pancreatic tumor animal model and evaluation of NOTES tumor enucleation. Surg Endosc 25(10):3191–3197PubMedCrossRef
13.
Zurück zum Zitat Matthes K, Yusuf TE, Willingham FF et al (2007) Feasibility of endoscopic transgastric distal pancreatectomy in a porcine animal model. Gastrointest Endosc 66(4):762–766PubMedCrossRef Matthes K, Yusuf TE, Willingham FF et al (2007) Feasibility of endoscopic transgastric distal pancreatectomy in a porcine animal model. Gastrointest Endosc 66(4):762–766PubMedCrossRef
14.
Zurück zum Zitat Horiguchi A, Uyama I, Ito M et al (2011) Robot-assisted laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Sci 18(4):488–492PubMedCrossRef Horiguchi A, Uyama I, Ito M et al (2011) Robot-assisted laparoscopic pancreatic surgery. J Hepatobiliary Pancreat Sci 18(4):488–492PubMedCrossRef
15.
Zurück zum Zitat Kang CM, Kim DH, Lee WJ et al (2011) Conventional laparoscopic and robot-assisted spleen-preserving pancreatectomy: does da Vinci have clinical advantages? Surg Endosc 25(6):2004–2009PubMedCrossRef Kang CM, Kim DH, Lee WJ et al (2011) Conventional laparoscopic and robot-assisted spleen-preserving pancreatectomy: does da Vinci have clinical advantages? Surg Endosc 25(6):2004–2009PubMedCrossRef
16.
Zurück zum Zitat Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc 24(7):1646–1657PubMedCrossRef Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc 24(7):1646–1657PubMedCrossRef
17.
Zurück zum Zitat Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic middle pancreatectomy. J Laparoendosc Adv Surg Tech A 20(2):135–139PubMedCrossRef Giulianotti PC, Sbrana F, Bianco FM et al (2010) Robot-assisted laparoscopic middle pancreatectomy. J Laparoendosc Adv Surg Tech A 20(2):135–139PubMedCrossRef
18.
Zurück zum Zitat Porembka MR, Hall BL, Hirbe M et al (2010) Quantitative weighting of postoperative complications based on the accordion severity grading system: demonstration of potential impact using the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 210(3):286–298PubMedCrossRef Porembka MR, Hall BL, Hirbe M et al (2010) Quantitative weighting of postoperative complications based on the accordion severity grading system: demonstration of potential impact using the American College of Surgeons National Surgical Quality Improvement Program. J Am Coll Surg 210(3):286–298PubMedCrossRef
19.
Zurück zum Zitat Bassi C, Dervenis C, Butturini G et al (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138(1):8–13PubMedCrossRef Bassi C, Dervenis C, Butturini G et al (2005) Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery 138(1):8–13PubMedCrossRef
20.
Zurück zum Zitat Edwin B, Mala T, Mathisen O et al (2004) Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg Endosc 18(3):407–411PubMedCrossRef Edwin B, Mala T, Mathisen O et al (2004) Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome. Surg Endosc 18(3):407–411PubMedCrossRef
21.
Zurück zum Zitat Pfluke JM, Parker M, Stauffer JA et al (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212(1):113–118PubMedCrossRef Pfluke JM, Parker M, Stauffer JA et al (2011) Laparoscopic surgery performed through a single incision: a systematic review of the current literature. J Am Coll Surg 212(1):113–118PubMedCrossRef
22.
Zurück zum Zitat Giulianotti PC, Kuechle J, Salehi P et al (2009) Robotic-assisted laparoscopic distal pancreatectomy of a redo case combined with autologous islet transplantation for chronic pancreatitis. Pancreas 38(1):105–107PubMedCrossRef Giulianotti PC, Kuechle J, Salehi P et al (2009) Robotic-assisted laparoscopic distal pancreatectomy of a redo case combined with autologous islet transplantation for chronic pancreatitis. Pancreas 38(1):105–107PubMedCrossRef
23.
Zurück zum Zitat Marangos IP, Buanes T, Rosok BI et al (2012) Laparoscopic resection of exocrine carcinoma in central and distal pancreas results in a high rate of radical resections and long postoperative survival. Surgery 151(5):717–723PubMedCrossRef Marangos IP, Buanes T, Rosok BI et al (2012) Laparoscopic resection of exocrine carcinoma in central and distal pancreas results in a high rate of radical resections and long postoperative survival. Surgery 151(5):717–723PubMedCrossRef
24.
Zurück zum Zitat Kooby DA, Hawkins WG, Schmidt CM et al (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(5):779–7PubMedCrossRef Kooby DA, Hawkins WG, Schmidt CM et al (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(5):779–7PubMedCrossRef
Metadaten
Titel
Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study
verfasst von
Sven-Petter Haugvik
Bård Ingvald Røsok
Anne Waage
Øystein Mathisen
Bjørn Edwin
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Langenbeck's Archives of Surgery / Ausgabe 8/2013
Print ISSN: 1435-2443
Elektronische ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-013-1133-y

Weitere Artikel der Ausgabe 8/2013

Langenbeck's Archives of Surgery 8/2013 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.