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J Hepatobiliary Pancreat Sci. 2019 Jun 18. doi: 10.1002/jhbp.646. [Epub ahead of print]

Single-port versus conventional laparoscopic distal pancreatectomy: a propensity score matched analysis and a learning curve of single-port approach.

Park P1,2, Han HJ1,3, Song TJ1,3, Choi SB1,2, Kim WB1,2, Yoo YD1,4, Kim DS1,4, Cha JH5.

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Department of Surgery, Korea University College of Medicine, 123 Jeokgeum-ro, Ansan-si, Gyeonggi-do, 15355, Korea.
Department of Surgery, Korea University Guro Hospital, Seoul, Korea.
Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, Ansan, Korea.
Department of Surgery, Korea University Anam Hospital, Seoul, Korea.
Medical Science Research Center, Korea University Ansan Hospital, Ansan, Korea.



Single-port laparoscopic approaches are well established in the field of minimally invasive surgery; however, single-port laparoscopic distal pancreatectomy (SPLDP) has not been evaluated in a large number of distal pancreatic neoplasms. We aimed to compare single-port laparoscopic distal pancreatectomy outcomes with conventional laparoscopic distal pancreatectomy (LDP) outcomes.


We retrospectively evaluated the medical records of 101 patients who underwent SPLDP (n = 26) or LDP (n = 75). We performed 1:1 propensity score matching between the two groups. Consequently, 26 patients were included in each group. We analyzed the learning curve based on the operation time in SPLDP.


Single-port laparoscopic distal pancreatectomy could be performed with fewer trocars (P < 0.001) and assistants (P < 0.001). However, compared to the LDP group, mean operation time was longer (278.9 vs. 178.7 min, P < 0.001) and splenic vessel preservation rates were lower (0% vs. 46.2%, P < 0.001) in the SPLDP group. The mean pain visual analogue scale score was significantly lower at postoperative day 1 (P < 0.001) and day 2 (P < 0.001) in the SPLDP group. The learning curve was determined in the 12th case for SPLDP.


Single-port laparoscopic distal pancreatectomy is comparable in safety to conventional laparoscopic approaches for distal pancreatic neoplasms, with fewer trocars, assistants and less pain; however, operation time was longer.


Distal pancreatectomy; Laparoscopic; Learning curve; Single-port


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