Laparoscopic Versus Open Distal Pancreatectomy: Comparative Analysis of Clinical Outcomes at a Single Institution.

PURPOSE Undertake a comparison between laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) for the management of benign and malignant lesions. METHODS A case series study of 93 consecutive patients subjected to a distal pancreatectomy for pancreatic tumors between 2001 and 2015. In each patient, clinical and surgical characteristic, postoperative course, histopathologic examination, and survival were analyzed. RESULTS LDP was associated with significantly less operative blood loss (50 mL vs. 300 mL; P<0.01), higher spleen preservation rate (52.6% vs. 19.2%; P<0.01) and shorter hospital stay (5 d vs. 8 d; P<0.01). In patients with adenocarcinoma, survival at 1 and 5 years were 63.5% and 15.9% in the ODP group versus 66.7% and 33.3% in the LDP group (P=0.43). CONCLUSIONS LDP is a safe and feasible procedure for DP resections. LDP offers advantages over ODP in terms of reduction of operative blood loss, higher spleen preservation rate, and shorter hospital stay.