Ann Hepatobiliary Pancreat Surg.  2019 Aug;23(3):252-257. 10.14701/ahbps.2019.23.3.252.

Outcome of minimally-invasive versus open pancreatectomies for solid pseudopapillary neoplasms of the pancreas: A 2:1 matched case-control study

Affiliations
  • 1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore. Bsgkp@hotmail.com

Abstract

BACKGROUNDS/AIMS
Solid pseudopapillary neoplasm (SPPN) is typically seen in young healthy females who would likely benefit from minimally-invasive pancreatectomy (MIP). A few comparative studies have suggested that MIP is associated with favorable outcomes when compared to the open approach for SPPN. This study aims to mitigate potential selection bias by performing a matched case-control study comparing MIP vs open pancreatectomy (OP) for SPPN.
METHODS
We performed a single-institution retrospective electronic chart review of all patients who underwent surgery for pathologically confirmed SPPN between 2000 and 2017. A 2:1 matched comparison using age, gender, tumor size and the type of pancreatectomy was performed between OP and MIP.
RESULTS
A total of 40 patients with a median age of 40.3 years (range 16.5-64.4) and female sex predominance (n=34, 85.0%) underwent surgery during the study period. Nine patients underwent MIP. Matched comparison between 18 OP and 9 MIP demonstrated that MIP was associated with a longer median operating time (305 vs 180 min, p=0.046) and shorter median postoperative stay (6 vs 9 days, p=0.015). There were no significant differences in intraoperative blood loss, blood transfusion requirements, postoperative morbidity (including postoperative pancreatic fistula) and mortality, resection margins, lymph node yield and long-term survival.
CONCLUSIONS
MIP is a safe and viable option in the management of SPPN with the benefit of a shorter postoperative length of stay at the expense of a longer operation time. There was no significant difference in oncologic outcomes between both groups of patients.

Keyword

Laparoscopic pancreatectomy; Minimally-invasive pancreatectomy; Robotic pancreatectomy; Solid pseudopapillary neoplasm

MeSH Terms

Blood Transfusion
Case-Control Studies*
Female
Humans
Length of Stay
Lymph Nodes
Mortality
Pancreas*
Pancreatectomy*
Retrospective Studies
Selection Bias
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