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2015•Journal of Hepato-Biliary-Pancreatic SciencesRequires access

Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score‐matching

Masafumi Nakamura, Go Wakabayashi, Yoshihiro Miyasaka, Masao Tanaka, Takanori Morikawa, Michiaki Unno, Hiroshi Tajima, Yusuke Kumamoto, Sohei Satoi, Masanori Kwon, Hirochika Toyama, Yonson Ku, Hideyuki Yoshitomi, Satoshi Nara, Kazuaki Shimada, Takahide Yokoyama, Shinichi Miyagawa, Yoichi Toyama, Katsuhiko K. Yanaga, Tsutomu Fujii, Yasuhiro Kodera, Study Group of JHBPS, JSEPS, Yasuyuki Tomiyama, Hiroaki Miyata, Takeshi Takahara, Toru Beppu, Hiroki Yamaue, Masaru Miyazaki, Tadahiro Takada

Open publisher page 123 citations

Abstract

BACKGROUND: Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. METHODS: We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. RESULTS: After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P < 0.001); lower rates of intraoperative transfusion (P = 0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P < 0.001), and morbidity (P < 0.001); and shorter hospital stay (P = 0.001), but a longer operative time (P < 0.001). CONCLUSIONS: Laparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.

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What this paper is about

BACKGROUND: Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. METHODS: We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. RESULTS: After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P < 0.001); lower rates of intraoperative transfusion (P = 0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P < 0.001), and morbidity (P < 0.001); and shorter hospital stay (P = 0.001), but a longer operative time (P < 0.001). CONCLUSIONS: Laparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.

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Available abstract

BACKGROUND: Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score-matching. METHODS: We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006-2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. RESULTS: After propensity score-matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P < 0.001); lower rates of intraoperative transfusion (P = 0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P < 0.001), and morbidity (P < 0.001); and shorter hospital stay (P = 0.001), but a longer operative time (P < 0.001). CONCLUSIONS: Laparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.

Key concepts: Medicine, Propensity score matching, Perioperative, Pancreatic fistula, Distal pancreatectomy, Pancreatectomy, Surgery, Laparoscopy

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Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score‐matching — Research Paper | ScholarLens