Comparison of the duration of hospital stay after laparoscopic or open distal pancreatectomy : randomized controlled trial
(2020) In British Journal of Surgery 107(10). p.1281-1288- Abstract
Background: Studies have suggested that laparoscopic distal pancreatectomy (LDP) is advantageous compared with open distal pancreatectomy (ODP) regarding hospital stay, blood loss and recovery. Only one randomized study is available, which showed enhanced functional recovery after LDP compared with ODP. Methods: Consecutive patients evaluated at a multidisciplinary tumour board and planned for standard distal pancreatectomy were randomized prospectively to LDP or ODP in an unblinded, parallel-group, single-centre superiority trial. The primary outcome was postoperative hospital stay. Results: Of 105 screened patients, 60 were randomized and 58 (24 women, 41 per cent) were included in the intention-to-treat analysis; there were 29... (More)
Background: Studies have suggested that laparoscopic distal pancreatectomy (LDP) is advantageous compared with open distal pancreatectomy (ODP) regarding hospital stay, blood loss and recovery. Only one randomized study is available, which showed enhanced functional recovery after LDP compared with ODP. Methods: Consecutive patients evaluated at a multidisciplinary tumour board and planned for standard distal pancreatectomy were randomized prospectively to LDP or ODP in an unblinded, parallel-group, single-centre superiority trial. The primary outcome was postoperative hospital stay. Results: Of 105 screened patients, 60 were randomized and 58 (24 women, 41 per cent) were included in the intention-to-treat analysis; there were 29 patients of mean age 68 years in the LDP group and 29 of mean age 63 years in the ODP group. The main indication was cystic pancreatic lesions, followed by neuroendocrine tumours. The median postoperative hospital stay was 5 (i.q.r. 4–5) days in the laparoscopic group versus 6 (5–7) days in the open group (P = 0·002). Functional recovery was attained after a median of 4 (i.q.r. 2–6) versus 6 (4–7) days respectively (P = 0·007), and duration of surgery was 120 min in both groups (P = 0·482). Blood loss was less with laparoscopic surgery: median 50 (i.q.r. 25–150) ml versus 100 (100–300) ml in the open group (P = 0·018). No difference was found in the complication rates (Clavien–Dindo grade III or above: 4 versus 8 patients respectively). The rate of delayed gastric emptying and clinically relevant postoperative pancreatic fistula did not differ between the groups. Conclusion: LDP is associated with shorter hospital stay than ODP, with shorter time to functional recovery and less bleeding.
(Less)
- author
- Björnsson, B. ; Larsson, A. Lindhoff ; Hjalmarsson, C. LU ; Gasslander, T. and Sandström, P.
- organization
- publishing date
- 2020-09
- type
- Contribution to journal
- publication status
- published
- subject
- in
- British Journal of Surgery
- volume
- 107
- issue
- 10
- pages
- 8 pages
- publisher
- Oxford University Press
- external identifiers
-
- scopus:85083109234
- pmid:32259297
- ISSN
- 0007-1323
- DOI
- 10.1002/bjs.11554
- language
- English
- LU publication?
- yes
- id
- 5b955bf3-8903-4ba2-b272-b06cc3f2d16f
- date added to LUP
- 2020-05-07 16:46:09
- date last changed
- 2024-06-13 15:55:00
@article{5b955bf3-8903-4ba2-b272-b06cc3f2d16f,
abstract = {{<p>Background: Studies have suggested that laparoscopic distal pancreatectomy (LDP) is advantageous compared with open distal pancreatectomy (ODP) regarding hospital stay, blood loss and recovery. Only one randomized study is available, which showed enhanced functional recovery after LDP compared with ODP. Methods: Consecutive patients evaluated at a multidisciplinary tumour board and planned for standard distal pancreatectomy were randomized prospectively to LDP or ODP in an unblinded, parallel-group, single-centre superiority trial. The primary outcome was postoperative hospital stay. Results: Of 105 screened patients, 60 were randomized and 58 (24 women, 41 per cent) were included in the intention-to-treat analysis; there were 29 patients of mean age 68 years in the LDP group and 29 of mean age 63 years in the ODP group. The main indication was cystic pancreatic lesions, followed by neuroendocrine tumours. The median postoperative hospital stay was 5 (i.q.r. 4–5) days in the laparoscopic group versus 6 (5–7) days in the open group (P = 0·002). Functional recovery was attained after a median of 4 (i.q.r. 2–6) versus 6 (4–7) days respectively (P = 0·007), and duration of surgery was 120 min in both groups (P = 0·482). Blood loss was less with laparoscopic surgery: median 50 (i.q.r. 25–150) ml versus 100 (100–300) ml in the open group (P = 0·018). No difference was found in the complication rates (Clavien–Dindo grade III or above: 4 versus 8 patients respectively). The rate of delayed gastric emptying and clinically relevant postoperative pancreatic fistula did not differ between the groups. Conclusion: LDP is associated with shorter hospital stay than ODP, with shorter time to functional recovery and less bleeding. </p>}},
author = {{Björnsson, B. and Larsson, A. Lindhoff and Hjalmarsson, C. and Gasslander, T. and Sandström, P.}},
issn = {{0007-1323}},
language = {{eng}},
number = {{10}},
pages = {{1281--1288}},
publisher = {{Oxford University Press}},
series = {{British Journal of Surgery}},
title = {{Comparison of the duration of hospital stay after laparoscopic or open distal pancreatectomy : randomized controlled trial}},
url = {{http://dx.doi.org/10.1002/bjs.11554}},
doi = {{10.1002/bjs.11554}},
volume = {{107}},
year = {{2020}},
}