Raghupathy Jaivikash, Lee Chuan-Yaw, Huan Sarah K W, Koh Ye-Xin, Tan Ek-Khoon, Teo Jin-Yao, Cheow Peng-Chung, Ooi London L P J, Chung Alexander Y F, Chan Chung-Yip, Goh Brian K P
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Academia, Level 5, 20 College Road, Singapore, 169856, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
World J Surg. 2022 Jan;46(1):207-214. doi: 10.1007/s00268-021-06306-x. Epub 2021 Sep 10.
Minimally invasive distal pancreatectomy (MIDP) is being adopted increasingly worldwide. This study aimed to compare the short-term outcomes of patients who underwent MIDP versus open distal pancreatectomy (ODP).
A retrospective review of all patients who underwent a DP in our institution between 2005 and 2019 was performed. Propensity score matching based on relevant baseline factors was used to match patients in the ODP and MIDP groups in a 1:1 manner. Outcomes reported include operative duration, blood loss, postoperative length of stay, morbidity, mortality, postoperative pancreatic fistula rates, reoperation and readmission.
In total, 444 patients were included in this study. Of 122 MIDP patients, 112 (91.8%) could be matched. After matching, the median operating time for MIDP was significantly longer than ODP [260 min (200-346.3) vs 180 (135-232.5), p < 0.001], while postoperative stay for MIDP was significantly shorter [median 6 days (5-8) versus 7 days (6-9), p = 0.015]. There were no significant differences noted in any of the other outcomes measured. Over time, we observed a decrease in the operation times of MIDP performed at our institution.
Adoption of MIDP offers advantages over ODP in terms of a shorter postoperative hospital stay, without an increase in morbidity and/or mortality but at the expense of a longer operation time.
微创远端胰腺切除术（MIDP）在全球范围内的应用越来越广泛。本研究旨在比较接受MIDP与开放远端胰腺切除术（ODP）患者的短期结局。
对2005年至2019年在我院接受远端胰腺切除术的所有患者进行回顾性研究。基于相关基线因素的倾向评分匹配用于以1:1的方式匹配ODP组和MIDP组的患者。报告的结局包括手术时间、失血量、术后住院时间、发病率、死亡率、术后胰瘘发生率、再次手术和再次入院情况。
本研究共纳入444例患者。122例MIDP患者中，112例（91.8%）可进行匹配。匹配后，MIDP的中位手术时间显著长于ODP[260分钟（200 - 346.3）vs 180（135 - 232.5），p < 0.001]，而MIDP的术后住院时间显著缩短[中位6天（5 - 8）对7天（6 - 9），p = 0.015]。在其他任何测量的结局方面均未发现显著差异。随着时间的推移，我们观察到我院进行的MIDP手术时间有所减少。
采用MIDP在术后住院时间较短方面优于ODP，且不增加发病率和/或死亡率，但代价是手术时间较长。
