Ann Hepatobiliary Pancreat Surg.  2019 Aug;23(3):258-264. 10.14701/ahbps.2019.23.3.258.

Minimally-invasive versus open enucleation for pancreatic tumours: A propensity-score adjusted analysis

Affiliations
  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. bsgkp@hotmail.com
  • 2Yong Loo Lin School of Medicine, Singapore.
  • 3Duke NUS Medical School, Singapore.

Abstract

BACKGROUNDS/AIMS
This study aims to evaluate the perioperative outcomes of minimally-invasive enucleation (MIEn) of the pancreas versus open enucleation (OEn).
METHODS
This is a retrospective review of 20 consecutive patients who underwent pancreatic enucleation at a single institution.
RESULTS
Seven patients underwent MIEn, of which 3 were robotic and 4 were laparoscopic. After propensity-adjusted analysis, the only significant difference was a reduced rate of readmissions within 30 days in the MIEn group versus the OEn group [0 vs 4 (30.8%), p=0.0464]. There were no conversions to open in the MIEn group, and median operation time was similar in both groups. There was no difference in median EBL in both groups, and none of the patients in our series required blood transfusions. The overall morbidity rate was 45.0% and the major complication (Clavien-Dindo>2) rate was 15%; which was similar between both groups. Seven (35%) patients had a Grade B/C POPF, and there was no significant difference between the two groups for this. The MIEn group had a shorter median length of stay compared to OEn [5 days (range, 3-24) vs 8.5 days (range, 5-42)] this was not significant on propensity-adjusted analysis (p=0.3195). There was no post-operative 90-day/in-hospital mortality in all 20 patients.
CONCLUSIONS
Our experience demonstrates that MIEn was associated with similar perioperative outcomes and fewer readmissions compared to OEn.

Keyword

Enucleation; Laparoscopic; Robotic; Minimally-invasive; Pancreas

MeSH Terms

Blood Transfusion
Humans
Length of Stay
Mortality
Pancreas
Retrospective Studies

Cited by  1 articles

Robotic enucleation of a pancreatic uncinate neuroendocrine tumor – a unique parenchyma-saving strategy for uncinate tumors
Ken Min Chin, Brian K. P. Goh
Ann Hepatobiliary Pancreat Surg. 2020;24(1):97-103.    doi: 10.14701/ahbps.2020.24.1.97.


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