Pankreas Kanserlerinde Laparoskopik ve Açık Whipple Prosedürünün Karşılaştırılması: Tek Merkez Sonuçları

Abstract

Background: The laparoscopic approach for pancreas tumors is not comprehensively approved, due to its technical complexity. The aim of this study was to compare the perioperative and postoperative results, oncological outcomes and survival of patients with proximal pancreatic tumor who underwent laparoscopic treatment (TLPD) versus open procedure (TPD).Patients and Methods: From 2009 to 2017, information of patients undergoing pancreatic resection was collected. All patients undergoing total pancreaticoduodenectomy (TPD) or TLPD were included in this study. The patients were followed minimum 6 months after surgery and all complications were analyzed. All complications were recorded and categorised according to the clavien system. Results: 62 (%80.5) patients underwent TPD, 15 (%19.4) underwent TLPD. There were no differences in patients demografics. Significant differences were determined in TLPD group about blood transfusion, blood loss, lenght of hospitalization, intensive care unit (ICU) stay, number of lymph nodes resected. Operative time was significantly long in TLPD group. Postpancreatectomy hemorragy was low in TLPD group. There were no differences in other complications. Conclusions: Laparoscopic whipple procedure is not only feasible but safe, with low morbidity and acceptable complication rates. TLPD is characterized by less blood loss, lower transfusion rates, improved lymph node resection, less wound infection. However, the laparoscopic Whipple procedure can be applied in selected cases.