Department of Hepatobiliary Surgery, Affiliated Dongyang Hospital of Wenzhou Medical University, Dongyang, Zhejiang, China.
Minim Invasive Ther Allied Technol. 2022 Mar;31(3):350-358. doi: 10.1080/13645706.2020.1812664. Epub 2020 Sep 9.
The surgical benefits of open distal pancreatectomy (ODP) and laparoscopic distal pancreatectomy (LDP) as a treatment for pancreatic disease in the body or tail were compared.
We searched PubMed, ClinicalTrials.gov, Cochrane Central Register of Controlled Trials, and Web of Science from 1 August 1990 to 1 July 2019. Studies comparing total LDP and ODP were included.
In total, we reviewed 30 studies covering 4040 subjects. The analysis displayed a similar incidence of CR-POPF and POPF between ODP and LDP groups. The findings indicate that LDP correlates with fewer total complications, lower estimated blood loss, shorter length of stay and shorter postoperative hospital stay. There was no significant difference in the operation time, R0 resection, postoperative hemorrhage, number of lymph nodes collected, reoperation, major complications, or mortality.
Application of the International Study Group on Pancreatic Fistula (2017) criteria in this meta-analysis showed that LDP had surgical outcomes comparable with those of ODP. However, LDP has the benefits of causing a relatively lower estimated blood loss, a small number of total complications, and a shorter hospital stay. We, however, note that further high-quality and controlled trials are required to comprehensively compare these treatments.
本研究旨在比较开腹胰体尾切除术（ODP）和腹腔镜胰体尾切除术（LDP）治疗胰体尾部病变的手术效果。
我们检索了 1990 年 8 月 1 日至 2019 年 7 月 1 日期间的 PubMed、ClinicalTrials.gov、Cochrane 对照试验中心注册库和 Web of Science 数据库，纳入比较 LDP 和 ODP 两种术式的研究。
共纳入 30 项研究，包含 4040 例患者。分析显示，ODP 和 LDP 组的严重并发症（CR-POPF 和 POPF）发生率相似。LDP 组总并发症、术中出血量、术后住院时间和住院总时间均少于 ODP 组，差异具有统计学意义，但两组间手术时间、R0 切除率、术后出血率、淋巴结清扫数目、中转开腹率、主要并发症发生率和死亡率差异均无统计学意义。
应用国际胰腺瘘研究小组（ISGPS）2017 年定义的胰腺瘘分级标准对上述研究进行分析，结果显示 LDP 与 ODP 相比，具有相似的手术效果，但术中出血量较少，总并发症发生率较低，术后住院时间较短。但是，仍需要进一步开展高质量的随机对照试验来全面比较两种术式。
