Laparoscopic Distal Pancreatectomy Following Prior Upper Abdominal Surgery (Pancreatectomy and Prior Surgery)
- PDF / 365,473 Bytes
- 8 Pages / 595.276 x 790.866 pts Page_size
- 104 Downloads / 238 Views
ORIGINAL ARTICLE
Laparoscopic Distal Pancreatectomy Following Prior Upper Abdominal Surgery (Pancreatectomy and Prior Surgery) Mushegh A. Sahakyan 1,2,3 & Tore Tholfsen 4 & Dyre Kleive 4 & Sheraz Yaqub 4 & Airazat M. Kazaryan 1,2,5,6 & Trond Buanes 3,7 & Bård Ingvald Røsok 4 & Knut Jørgen Labori 4 & Bjørn Edwin 1,3,4,7 Received: 2 August 2020 / Accepted: 31 October 2020 # 2020 The Author(s)
Abstract Background and Purpose Previous abdominal surgery can be a risk factor for perioperative complications in patients undergoing laparoscopic procedures. Today, distal pancreatectomy is increasingly performed laparoscopically. This study investigates the consequences of prior upper abdominal surgery (PUAS) for laparoscopic distal pancreatectomy (LDP). Methods Patients who had undergone LDP from April 1997 to January 2020 were included. Based on the history and type of PUAS, these were categorized into three groups: minimally invasive (I), open (II), and no PUAS (III). To reduce possible confounding factors, the groups were matched in 1:2:4 fashion based on age, sex, body mass index (BMI) and American Society of Anesthesiology grade. Results After matching, 30, 60, and 120 patients were included in the minimally invasive, open and no PUAS groups, respectively. No statistically significant differences were found in terms of intraoperative outcomes. Postoperative morbidity, mortality and length of hospital stay were similar. Open PUAS was associated with higher Comprehensive Complication Index (33.7 vs 20.9 vs 26.2, p = 0.03) and greater proportion of patients with ≥ 2 complications (16.7 vs 0 vs 6.7%, p = 0.02) compared with minimally invasive and no PUAS. Male sex, overweight (BMI 25–29.9 kg/m2), diagnosis of neuroendocrine neoplasia, and open PUAS were risk factors for severe morbidity in the univariable analysis. Only open PUAS was statistically significant in the multivariable model. Conclusions PUAS does not impair the feasibility and safety of LDP as its perioperative outcomes are largely comparable to those in patients without PUAS. However, open PUAS increases the burden and severity of postoperative complications. Keywords Laparoscopy . Pancreatectomy . Surgery . Abdomen . Morbidity
* Mushegh A. Sahakyan [email protected] 1
The Intervention Center, Oslo University Hospital, Pikshospitalet, 0027 Oslo, Norway
2
Department of Surgery N1, Yerevan State Medical University After M. Heratsi, Yerevan, Armenia
3
Department of Research & Development, Division of Emergencies and Critical Care , Oslo University Hospital , Oslo, Norway
4
Department of HPB Surgery, Oslo University Hospital, Pikshospitalet, Oslo, Norway
5
Department of Gastrointestinal Surgery, Østfold Hospital Trust, Grålum, Norway
6
Department of Faculty Surgery N2, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
7
Institute of Clinical Medicine, Medical Faculty, University of Oslo, Oslo, Norway
Introduction Laparoscopic distal pancreatectomy (LDP) is becoming a standard modality in the treatment of lesions in the pa
Data Loading...
