Plahuta Irena, Šarenac Žan, Golob Medeja, Turk Špela, Ilijevec Bojan, Magdalenić Tomislav, Potrč Stojan, Ivanecz Arpad
Clinical Department of Abdominal and General Surgery, University Medical Centre Maribor, Ljubljanska Ulica 5, 2000 Maribor, Slovenia.
Department of Surgery, Faculty of Medicine, University of Maribor, Taborska Ulica 8, 2000 Maribor, Slovenia.
Life (Basel). 2025 Jan 14;15(1):97. doi: 10.3390/life15010097.
Laparoscopic distal pancreatectomy is a minimally invasive approach for the surgical treatment of neoplasms in the distal pancreas. This study aimed to compare this approach to the open procedure. A retrospective analysis of a prospectively maintained database of 400 pancreatectomies was performed. The laparoscopic distal pancreatectomy group (LDP) was compared to the open distal pancreatectomy group (ODP). A propensity score matching analysis (PSM) was performed. From 2016 to 2023, 108 distal pancreatectomies were carried out, 19 (17.6%) laparoscopically and 89 (82.4%) openly. The conversion rate was 13.6%. The severe morbidity rates were 28.1% in the ODP group, 47.4% in the LDP group, and 15.8% in the ODP-PSM group. The difference between the latter two was statistically significant ( = 0.034) due to the high rate of Clavien-Dindo grade 3a complications (42.1% versus 10.5%, = 0.042) in the LDP group. The 90-day mortality rates were 3.3% in the ODP group and 5.3% in the other two groups. The LDP group had a shorter duration of intravenous narcotic analgesia (5 versus 7 days, = 0.041). There was no difference in the R0 resection or postoperative pancreatic fistula rates. Our attention should be drawn to preventing postoperative complications because the oncological outcomes are already comparable with those of the open procedure, and postoperative pain management is promising.
腹腔镜远端胰腺切除术是一种用于外科治疗胰腺远端肿瘤的微创方法。本研究旨在比较这种方法与开放手术。对一个前瞻性维护的包含400例胰腺切除术的数据库进行了回顾性分析。将腹腔镜远端胰腺切除术组（LDP）与开放远端胰腺切除术组（ODP）进行比较。进行了倾向评分匹配分析（PSM）。2016年至2023年期间，共进行了108例远端胰腺切除术，其中19例（17.6%）为腹腔镜手术，89例（82.4%）为开放手术。中转率为13.6%。ODP组的严重发病率为28.1%，LDP组为47.4%，ODP-PSM组为15.8%。由于LDP组Clavien-Dindo 3a级并发症发生率较高（42.1%对10.5%，P = 0.042），后两组之间的差异具有统计学意义（P = 0.034）。ODP组的90天死亡率为3.3%，其他两组为5.3%。LDP组静脉注射麻醉镇痛的持续时间较短（5天对7天，P = 0.041）。R0切除率或术后胰瘘发生率无差异。我们应注意预防术后并发症，因为肿瘤学结果已与开放手术相当，且术后疼痛管理前景良好。
