Tags

Type your tag names separated by a space and hit enter

Outcomes analysis of laparoscopic resection of pancreatic neoplasms.
Surg Endosc. 2007 Apr; 21(4):579-86.SE

Abstract

BACKGROUND

Experience with laparoscopic resection of pancreatic neoplasms remains limited. The purpose of this study is to critically analyze the indications for and outcomes after laparoscopic resection of pancreatic neoplasms.

METHODS

The medical records of all patients undergoing laparoscopic resection of pancreatic neoplasms from July 2000 to February 2006 were reviewed. Data are expressed as mean +/- standard deviation.

RESULTS

Laparoscopic pancreatic resection was performed in 22 patients (M:F, 8:14) with a mean age of 56.3 +/- 15.1 years and mean body mass index (BMI) of 26.3 +/- 4.5 kg/m2. Nine patients had undergone previous intra-abdominal surgery. Indications for pancreatic resection were cyst (1), glucagonoma (1), gastrinoma (2), insulinoma (3), metastatic tumor (2), IPMT (4), nonfunctioning neuroendocrine tumor (3), and mucinous/serous cystadenoma (6). Mean tumor size was 2.4 +/- 1.6 cm. Laparoscopic distal pancreatectomy was attempted in 18 patients and completed in 17, and enucleation was performed in 4 patients. Laparoscopic ultrasound (n = 10) and a hand-assisted technique (n = 4) were utilized selectively. Mean operative time was 236 +/- 60 min and mean blood loss was 244 +/- 516 ml. There was one conversion to an open procedure because of bleeding from the splenic vein. The mean postoperative LOS was 4.5 +/- 2.0 days. Seven patients experienced a total of ten postoperative complications, including a urinary tract infection (UTI) (1), lower-extremity deep venous thrombosis (DVT) and pulmonary embolus (1), infected peripancreatic fluid collection (1), pancreatic pseudocyst (1), and pancreatic fistula (6). Five pancreatic fistulas were managed by percutaneous drainage. The reoperation rate was 4.5% and the overall pancreatic-related complication rate was 36.4%. One patient developed pancreatitis and a pseudocyst 5 months postoperatively, which was managed successfully with a pancreatic duct stent. There was no 30-day mortality.

CONCLUSIONS

Laparoscopic pancreatic resection is safe and feasible in selected patients with pancreatic neoplasms. With a pancreatic duct leak rate of 27%, this problem remains an area of development for the minimally invasive technique.

Authors+Show Affiliations

Department of Surgery, Washington University School of Medicine, 660 South Euclid Avenue, St. Louis, MO 63110, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17180287

Citation

Pierce, R A., et al. "Outcomes Analysis of Laparoscopic Resection of Pancreatic Neoplasms." Surgical Endoscopy, vol. 21, no. 4, 2007, pp. 579-86.
Pierce RA, Spitler JA, Hawkins WG, et al. Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surg Endosc. 2007;21(4):579-86.
Pierce, R. A., Spitler, J. A., Hawkins, W. G., Strasberg, S. M., Linehan, D. C., Halpin, V. J., Eagon, J. C., Brunt, L. M., Frisella, M. M., & Matthews, B. D. (2007). Outcomes analysis of laparoscopic resection of pancreatic neoplasms. Surgical Endoscopy, 21(4), 579-86.
Pierce RA, et al. Outcomes Analysis of Laparoscopic Resection of Pancreatic Neoplasms. Surg Endosc. 2007;21(4):579-86. PubMed PMID: 17180287.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Outcomes analysis of laparoscopic resection of pancreatic neoplasms. AU - Pierce,R A, AU - Spitler,J A, AU - Hawkins,W G, AU - Strasberg,S M, AU - Linehan,D C, AU - Halpin,V J, AU - Eagon,J C, AU - Brunt,L M, AU - Frisella,M M, AU - Matthews,B D, Y1 - 2006/12/16/ PY - 2006/06/10/received PY - 2006/07/05/accepted PY - 2006/06/10/revised PY - 2006/12/21/pubmed PY - 2007/4/14/medline PY - 2006/12/21/entrez SP - 579 EP - 86 JF - Surgical endoscopy JO - Surg Endosc VL - 21 IS - 4 N2 - BACKGROUND: Experience with laparoscopic resection of pancreatic neoplasms remains limited. The purpose of this study is to critically analyze the indications for and outcomes after laparoscopic resection of pancreatic neoplasms. METHODS: The medical records of all patients undergoing laparoscopic resection of pancreatic neoplasms from July 2000 to February 2006 were reviewed. Data are expressed as mean +/- standard deviation. RESULTS: Laparoscopic pancreatic resection was performed in 22 patients (M:F, 8:14) with a mean age of 56.3 +/- 15.1 years and mean body mass index (BMI) of 26.3 +/- 4.5 kg/m2. Nine patients had undergone previous intra-abdominal surgery. Indications for pancreatic resection were cyst (1), glucagonoma (1), gastrinoma (2), insulinoma (3), metastatic tumor (2), IPMT (4), nonfunctioning neuroendocrine tumor (3), and mucinous/serous cystadenoma (6). Mean tumor size was 2.4 +/- 1.6 cm. Laparoscopic distal pancreatectomy was attempted in 18 patients and completed in 17, and enucleation was performed in 4 patients. Laparoscopic ultrasound (n = 10) and a hand-assisted technique (n = 4) were utilized selectively. Mean operative time was 236 +/- 60 min and mean blood loss was 244 +/- 516 ml. There was one conversion to an open procedure because of bleeding from the splenic vein. The mean postoperative LOS was 4.5 +/- 2.0 days. Seven patients experienced a total of ten postoperative complications, including a urinary tract infection (UTI) (1), lower-extremity deep venous thrombosis (DVT) and pulmonary embolus (1), infected peripancreatic fluid collection (1), pancreatic pseudocyst (1), and pancreatic fistula (6). Five pancreatic fistulas were managed by percutaneous drainage. The reoperation rate was 4.5% and the overall pancreatic-related complication rate was 36.4%. One patient developed pancreatitis and a pseudocyst 5 months postoperatively, which was managed successfully with a pancreatic duct stent. There was no 30-day mortality. CONCLUSIONS: Laparoscopic pancreatic resection is safe and feasible in selected patients with pancreatic neoplasms. With a pancreatic duct leak rate of 27%, this problem remains an area of development for the minimally invasive technique. SN - 1432-2218 UR - https://www.unboundmedicine.com/medline/citation/17180287/Outcomes_analysis_of_laparoscopic_resection_of_pancreatic_neoplasms_ L2 - https://doi.org/10.1007/s00464-006-9022-x DB - PRIME DP - Unbound Medicine ER -