Comparison Of Short-term Cl Ini Cal Outcomes Between Laparoscopic Distal Pancreatectomy And Open Distal Pancreatectomy

Background/Aim:With the development of laparoscopic technology,laparoscopic technology is more and more widely used.Due to the complex anatomical position of pancreas、special pancreatic tissue and high incidence of postoperative complications,laparoscopy has not been widely used in the field of pancreatic surgery.Comparing the clinicopathological datas of the laparoscopyic distal pancreatectomy(LDP)and the open distal pancreatectomy(ODP)be to explore the safety,feasibility and short-term clinical effect of laparoscopic pancreatectomy.Materials and Methods:We performed a retrospective study on 161 pancreatic body and tail tumor patients who underwent pancreatectomy between September 2017 to December 2018 in the Department of Pancreatic and Gastric Surgery,Cancer Hospital of Chinese Academy of Medical Sciences.According to the mode of operation,the patients were divided into the LDP group(n=43)and the ODP group(n=118).To observe the short-term clinical effects and safety of the LDP group,the preoperative clinical data,operation related indexes,postoperative complications,postoperative recovery indexes,preioperative inflammatory indexes were analyzed.Results:The preoperative clinical characteristics between the LDP group and the ODP group was no statistical significance(p>0.05)).The intraoperative blood loss in the LDP group[(194.19±241.83)ml]was significantly less than that in the ODP group[(315.17±295.94)ml,p<0.05],the postoperative exhaust time in the LDP group[(3.00±0.72)d]was significantly shorter than that in the OPD group[(4.05±0.97)d,p<0.001];the time of getting out of bed in the LDP group[(3.00±0.72)d]was significantly shorter than that in the OPD group[(3.55±1.05)d,p<0.05],the postoperative feeding time in the LDP group was distinctly shorter than that in the ODP group[(5.11±1.56)d,p<0.001],the time of removal of the drainage tube in the LDP group[((8.44±1.93)d]was significantly shorter than that in the ODP group[(9.82±3.70)d,p<0.05],the postoperative hospital stay in the LDP group[(9.65±3.57)d]was significantly shorter than that in the ODP group[(11.99±6.57)d,p<0.05].The mean time of operation in the LDP group was[(168.65±55.45)min]was shorter than that in the ODP group[(171.23±65.61)min,p>0.05],but the difference did not reach statistical significance.The incidence of non-pancreatic fistula-related complications between the LDP group(16.3%)and the ODP group was no statistical significance(11.0%,p>0.05).The incidence of pancreatic fistula between the LDP group(16.3%)and the ODP group was no difference(19.5%,p>0.05).The total incidence of complications had no statistical significance between the LDP(32.6%)and the ODP(30.5%,p>0.05).The difference between the two groups about the preoperative or postoperative inflammatory indexes did not reach statistical significance(p>0.05).Conclusions:Compared with the ODP,the LDP has the advantages of less intraoperative blood loss,faster postoperative recovery,shorter postoperative hospital stay and does not increase the postoperative complications and prolong operation time.LDP is a safe and feasible operation method,and its short-term clinical effect is better than that of ODP.