| Abstract |
BACKGROUND: Few data are available concerning short-term results of minimally invasive surgery in patients?>?70 years old requiring distal pancreatectomy. The aim of this study was to compare short-term results after laparoscopic (LDP) versus open distal pancreatectomy (ODP) in this subgroup of patients.
METHODS: All patients?>?70 years who underwent distal pancreatectomy in 3 expert centers between 1995 and 2017 were included and data were retrospectively analyzed. Demographic, intraoperative data and postoperative outcomes in LDP and ODP groups were compared.
RESULTS: A distal pancreatectomy was performed in 109 elderly patients; LDP group included 53 patients while ODP group included 56. There were 55 (50.5%) males and 54 (49.5%) women with a median age of 75 years (range 70-87). Fifty (45.9%) patients were 70-74, 40 (36.7%) patients were 75-79, and 19 (17.4%) patients were over 80 years. Nine (8.2%) patients required conversion to open surgery. The median operative time was not different between LDP and ODP (204 vs. 220 min, p?=?0.62). The intraoperative blood loss was significantly lower in the LDP group (238?±?312 vs. 425?±?582 ml, p?=?0.009) with no difference regarding the intraoperative transfusion rate. 90-day mortality (0 vs. 5%, p?=?0.42), overall complication (45.4 vs. 51.8%, p?=?0.53), major complication (18.2 vs. 12.5%, p?=?0.43), grade B/C pancreatic fistula (6.8 vs. 7.1%, p?=?0.71), were comparable in the 2 groups. Only postoperative confusion rate was significantly lower in the LDP group (4.5 vs. 25%, p?=?0.01). Median length of stay was significantly lower in the LDP group (14?±?10 vs. 16?±?11 days, p?=?0.04). R0 resection was performed in 94% of LDP patients and 89% in ODP patients without significant difference (p?=?0.73).
CONCLUSIONS: The laparoscopic approach seems to reduce blood loss, postoperative confusion, and length of stay in elderly patients requiring distal pancreatectomy. |
Institut de Recherche en Cancérologie de
