Laparoscopic versus open distal pancreatectomy: a single-institution comparative study

BACKGROUND: This study was designed to compare clinical outcomes for laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) performed at a single institution. METHODS: This retrospective study included 43 patients who underwent distal pancreatectomy between 2009 and 2013. The patients were divided into two groups based on the surgical approach: the laparoscopic surgery group (n = 20) and the open surgery group (n = 23). All clinical data were analyzed retrospectively. RESULTS: There were no significant differences in operation time, rate of intraoperative transfusions, complications, or mortality between the two groups. The intraoperative blood loss (210 ± 84.4 mL vs. 420 ± 91.1 mL), first flatus time (1.5 ± 1 d vs. 4 ± 2.5 d), diet start time (2 ± 0.7 d vs. 6 ± 1.8 d), and postoperative hospital stay (8 ± 3.5 d vs. 14 ± 5.5 d) were significantly less in the LDP group than in the ODP group. All patients had negative surgical margins at final pathology. There were no significant differences in the number of lymph nodes harvested (10 ± 2.1 vs. 11 ± 3.2) between the two groups. CONCLUSIONS: LDP is a feasible and safe surgical approach as well as ODP, but has the advantages of an earlier return to normal bowel movements, normal diet, and shorter hospital stays than ODP.