Laparoscopic versus Open Distal Pancreatectomy for Left-sided Pancreatic Lesions: A Retrospective Analysis of 206 Cases

Abstract

Backgrounds: Previous studies report successful application of laparoscopic distal pancreatectomy (LDP). However, its application for left-sided pancreatic lesions is still being debated and considered as challenging procedure. Our study aimed to evaluate the safety and clinical efficacy of laparoscopic versus open distal pancreatectomy(ODP) for left-sided lesions. Methods: From January 2014 to March 2019, 206 patients with left-sided pancreatic lesions in Tongji Hospital, Wuhan, China were enrolled into our study. 128 (62.14%) patients with LDP were compared with 78 (37.86%) patients who underwent ODP retrospectively. Results: Compared with ODP group, the operation time of LDP group was shorter (P = 0.029), the amount of bleeding was less, and the proportion of blood transfusion was lower. There was no perioperative death in both groups. The incidences of grade III and IV complications were 12.8% and 21.1% in ODP and LDP group respectively, with no significant difference (P = 0.198). In terms of postoperative pancreatic fistula, there were 16 (20.5%) cases in ODP group, 26 (20.3%) cases in LDP group with no significant difference (P = 0.952). There was no significant difference between the two groups in other postoperative complications. The length of first hospitalization in ODP group was 28 (22-36) days, and that in the LDP group was 25 (19.5-30) days, with statistical difference (P = 0.04). Conclusion: LDP for left-sided lesions is associated with reduced operation time, blood loss, and hospital stay than ODP. LDP can be performed safely and effectively in selected patients with left-sided lesions.