Article

Systematic Review of Minimally Invasive Pancreatic Resection

Cancer Biomarkers and Prevention Group, Department of Cancer Studies and Molecular Medicine, Bio centre, University of Leicester, University Road, Leicester LE1 7RH, UK.
Journal of Gastrointestinal Surgery (Impact Factor: 2.39). 02/2009; 13(6):1129-37. DOI: 10.1007/s11605-008-0797-z
Source: PubMed

ABSTRACT Pancreatic resection is associated with a significant morbidity. Efforts to reduce hospital stay and enhance recovery have seen the introduction of minimally invasive surgical techniques. This article reviews the current published literature on the safety and efficacy of minimally invasive surgery of the pancreas.
An electronic search of the PubMed and Embase databases was performed from 1996 to May 2008 to identify all relevant publications; studies meeting predefined inclusion criteria were retrieved and analyzed using a standardized protocol. Data on the safety and efficacy of minimally invasive surgery of the pancreas were recorded and analyzed.
Of 565 abstracts reviewed, 39 studies were identified as eligible for inclusion. There were 37 case series and two case control studies. Compared with open pancreatic surgery, minimally invasive pancreatic resection is similar in terms of morbidity and mortality. Blood loss and length of stay are decreased.
Laparoscopic distal pancreatic resection and enucleation of insulinoma appear to be safe procedures with reduced hospital stay, though morbidity remains significant. The evidence for laparoscopic pancreaticoduodenectomy is in its infancy, but the authors feel it is unlikely that many centers will achieve sufficient case load to make the introduction of minimally invasive resection feasible.

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    • "The short term outcomes of the published series suggest less blood loss and shorter hospital stay compared to open enucleation [9] [45] with no mortality. Morbidity appears to be comparable, in particular POPF rates which remain in the region of 29% [9]. In addition, long term results are lacking in the literature. "
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    ABSTRACT: Pancreatic surgery was reported as early as 1898. Since then significant developments have been made in the field of pancreatic resections. In addition, advances in laparoscopic surgery in general have seen the description of this approach in pancreatic surgery with increasing frequency. Although there are no randomized controlled trials, several large series and comparative studies have reported on the short and long term outcome of laparoscopic pancreatic surgery. Furthermore, in the last decade published systematic reviews and meta-analyses have reported on cost effectiveness and outcomes of these procedures.
    Best practice & research. Clinical gastroenterology 02/2014; 28(1):123-132. DOI:10.1016/j.bpg.2013.11.011 · 3.28 Impact Factor
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    • "The short term outcomes of the published series suggest less blood loss and shorter hospital stay compared to open enucleation [9] [45] with no mortality. Morbidity appears to be comparable, in particular POPF rates which remain in the region of 29% [9]. In addition, long term results are lacking in the literature. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Pancreatic surgery was reported as early as 1898. Since then significant developments have been made in the field of pancreatic resections. In addition, advances in laparoscopic surgery in general have seen the description of this approach in pancreatic surgery with increasing frequency. Although there are no randomized controlled trials, several large series and comparative studies have reported on the short and long term outcome of laparoscopic pancreatic surgery. Furthermore, in the last decade published systematic reviews and meta-analyses have reported on cost effectiveness and outcomes of these procedures.
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    ABSTRACT: Since its advent nearly 15 years ago, minimally invasive distal pancreatectomy has gradually increased in popularity. Numerous reports have now documented the safety and feasibility of the laparoscopic approach to left-sided pancreas resections, and large-scale comparisons have been made between the laparoscopic and open approaches regarding perioperative outcomes for both benign and malignant lesions. Furthermore, several high-volume centers have described their initial experiences with robotic distal pancreatectomy in comparison with laparoscopic and open resections. This review summarizes the literature for both laparoscopic and robotic distal pancreatectomy over the past year, highlighting novel advances. Although studies suggest that minimally invasive distal pancreatectomy is equivalent if not superior to the open approach in some respects, randomized studies are needed to best delineate the putative benefits.
    06/2013; 1(2). DOI:10.1007/s40137-013-0014-1
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