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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.

Author information

1
Department of Surgery, Korea University College of Medicine, 123 Jeokgeum-ro, Ansan-si, Gyeonggi-do, 15355, Korea.
2
Department of Surgery, Korea University Guro Hospital, Seoul, Korea.
3
Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, Ansan, Korea.
4
Department of Surgery, Korea University Anam Hospital, Seoul, Korea.
5
Medical Science Research Center, Korea University Ansan Hospital, Ansan, Korea.

Abstract

BACKGROUND:

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.

METHODS:

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.

RESULTS:

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.

CONCLUSIONS:

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.

KEYWORDS:

Distal pancreatectomy; Laparoscopic; Learning curve; Single-port

PMID:
31211913
DOI:
10.1002/jhbp.646

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