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Short- and long-term outcomes after minimally invasive versus open spleen-saving distal pancreatectomies.
Chee, Madeline; Lee, Chuan-Yaw; Lee, Ser-Yee; Ooi, London L P J; Chung, Alexander Y F; Chan, Chung-Yip; Goh, Brian K P.
Afiliação
  • Chee M; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
  • Lee CY; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
  • Lee SY; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital; Duke-Nus Medical School, Singapore.
  • Ooi LLPJ; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital; Duke-Nus Medical School, Singapore.
  • Chung AYF; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital; Duke-Nus Medical School, Singapore.
  • Chan CY; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital; Duke-Nus Medical School, Singapore.
  • Goh BKP; Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital; Duke-Nus Medical School, Singapore.
J Minim Access Surg ; 18(1): 118-124, 2022.
Article em En | MEDLINE | ID: mdl-33885021
ABSTRACT

INTRODUCTION:

This study aimed to compare the perioperative outcomes of patients who underwent minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) versus open surgery SPDP (O-SPDP). It also aimed to determine the long-term vascular patency after spleen-saving vessel-preserving distal pancreatectomies (SSVDPs).

METHODS:

A retrospective review of 74 patients who underwent successful SPDP and met the study criteria was performed. Of these, 67 (90.5%) patients underwent SSVDP, of which 38 patients (21 open, 17 MIS) had adequate long-term post-operative follow-up imaging to determine vascular patency.

RESULTS:

Fifty-one patients underwent open SPDP, whereas 23 patients underwent minimally invasive SPDP, out of which 10 (43.5%) were laparoscopic and 13 (56.5%) were robotic. Patients who underwent MI-SPDP had significantly longer operative time (307.5 vs. 162.5 min, P = 0.001) but shorter hospital stay (5 vs. 7 days, P = 0.021) and lower median blood loss (100 vs. 200 cc, P = 0.046) compared to that of O-SPDP. Minimally-invasive spleen-saving vessel-preserving distal pancreatectomy (MI-SSVDP) was associated with poorer long-term splenic vein patency rates compared to O-SSVDP (P = 0.048). This was particularly with respect to partial occlusion of the splenic vein, and there was no significant difference between the complete splenic vein occlusion rates between the MIS group and open group (29.4% vs. 28.6%, P = 0.954). The operative time was statistically significantly longer in patients who underwent robotic surgery versus laparoscopic surgery (330 vs. 173 min, P = 0.008).

CONCLUSION:

Adoption of MI-spleen-preserving distal pancreatectomy (SPDP) is safe and feasible. MI-SPDP is associated with a shorter hospital stay, lower blood loss but longer operation time compared to O-SPDP. In the present study, MI-SSVDP was associated with poorer long-term splenic vein patency rates compared to O-SSVDP.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Minim Access Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Singapura

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Idioma: En Revista: J Minim Access Surg Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Singapura