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CLC number: R735.9

On-line Access: 2017-06-05

Received: 2016-12-03

Revision Accepted: 2017-03-04

Crosschecked: 2017-05-08

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Citations:  Bibtex RefMan EndNote GB/T7714


Ai-bin Zhang


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Journal of Zhejiang University SCIENCE B 2017 Vol.18 No.6 P.532-538


Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience

Author(s):  Ai-bin Zhang, Ye Wang, Chen Hu, Yan Shen, Shu-sen Zheng

Affiliation(s):  Department of Surgery, the First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310003, China

Corresponding email(s):   shusenzheng@zju.edu.cn

Key Words:  Laparoscopic distal pancreatectomy, Open distal pancreatectomy, Pancreatic neoplasm, Pancreatic fistula

Ai-bin Zhang, Ye Wang, Chen Hu, Yan Shen, Shu-sen Zheng. Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience[J]. Journal of Zhejiang University Science B, 2017, 18(6): 532-538.

@article{title="Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience",
author="Ai-bin Zhang, Ye Wang, Chen Hu, Yan Shen, Shu-sen Zheng",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience
%A Ai-bin Zhang
%A Ye Wang
%A Chen Hu
%A Yan Shen
%A Shu-sen Zheng
%J Journal of Zhejiang University SCIENCE B
%V 18
%N 6
%P 532-538
%@ 1673-1581
%D 2017
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1600541

T1 - Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center experience
A1 - Ai-bin Zhang
A1 - Ye Wang
A1 - Chen Hu
A1 - Yan Shen
A1 - Shu-sen Zheng
J0 - Journal of Zhejiang University Science B
VL - 18
IS - 6
SP - 532
EP - 538
%@ 1673-1581
Y1 - 2017
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1600541

Objective: The aim of this study was to compare complications and oncologic outcomes of patients undergoing laparoscopic distal pancreatectomy (LDP) and open distal pancreatectomy (ODP) at a single center. Methods: Distal pancreatectomies performed for pancreatic ductal adenocarcinoma during a 4-year period were included in this study. A retrospective analysis of a database of this cohort was conducted. Results: Twenty-two patients underwent LDP for pancreatic ductal adenocarcinoma, in comparison to seventy-six patients with comparable tumor characteristics treated by ODP. No patients with locally advanced lesions were included in this study. Comparing LDP group to ODP group, there were no significant differences in operation time (P=0.06) or blood loss (P=0.24). Complications (pancreatic fistula, P=0.62; intra-abdominal abscess, P=0.44; postpancreatectomy hemorrhage, P=0.34) were similar. There were no significant differences in the number of lymph nodes harvested (11.2±4.6 in LDP group vs. 14.4±5.5 in ODP group, P=0.44) nor the rate of patients with positive lymph nodes (36% in LDP group vs. 41% in ODP group, P=0.71). Incidence of positive margins was similar (9% in LDP group vs. 13% in ODP group, P=0.61). The mean overall survival time was (29.6±3.7) months for the LDP group and (27.6±2.1) months for ODP group. There was no difference in overall survival between the two groups (P=0.34). Conclusions: LDP is a safe and effective treatment for selected patients with pancreatic ductal adenocarcinoma. A slow-compression of pancreas tissue with the GIA stapler is effective in preventing postoperative pancreatic fistula. The oncologic outcome is comparable with the conventional open approach. Laparoscopic radical antegrade modular pancreatosplenectomy contributed to oncological clearance.


结论:22例胰腺导管腺癌进行了LDP手术,76例病人进行了ODP手术。比较LDP和ODP组,两组在胰漏(P=0.62)、腹腔内脓肿(P=0.44)和术后出血(P=0.34)发生率无显著性差异。LDP组和ODP组术中获取的淋巴结数量(11.2±4.6 vs. 14.4±5.5,P=0.44)和淋巴结阳性病例数(36% vs. 41%,P=0.71)无显著性差异。切缘阳性发生率(9% vs. 13%, P=0.61)也无显著性差异。LDP组平均生存期(29.6±3.7)月,ODP组为(27.6±2.1)月,无显著性差异(P=0.35)。综上所述,腹腔镜胰体尾切除术对早期的胰腺导管癌是安全有效的。采用endo-GIA缓慢压榨方法可以预防术后胰漏发生,腹腔镜下根治性顺行模块化胰腺切除有利于肿瘤清除。腹腔镜手术可以达到和传统开腹手术相似的肿瘤清除效果。


Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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