Elsevier

HPB

Volume 21, Issue 6, June 2019, Pages 669-678
HPB

Original article
A nationwide cohort study of resection rates and short-term outcomes in open and laparoscopic distal pancreatectomy

https://doi.org/10.1016/j.hpb.2018.10.006Get rights and content
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Abstract

Background

Distal pancreatectomy (DP) is increasingly done by laparoscopy but data from routine practise are scarce. We describe practise in a national cohort.

Methods

Data from the Norwegian Patient Register of all patients undergoing DP from 2012 to 2016. National resection rates were analysed. Short-term outcomes include length of stay, reoperation, readmissions and 90-day mortality. Risk is reported as odds ratio (OR) with 95% confidence interval (c.i.).

Results

Of 554 procedures, 327 (59%) were laparoscopic. Median age was 66 years (iqr 55–72) and 52% were women. Resection rates increased during the period for all DP (from 1.76 to 2.39 per 100.000/yr), and significantly for laparoscopic DP (adjusted R-square 0.858; P = 0.015). Elderly patients had more resection (r2 = 0.11; P = 0.019). Splenectomy (n = 427; 77%) was less likely with laparoscopy (laparoscopy 72% vs open 84%, respectively; OR 0.64, 95% c.i. 0.42–0.97; P = 0.035). Multivisceral resections occurred more often in open DP (5.3% vs 1.2% for laparoscopy, OR 4.51, 1.44–14.2; P = 0.008). Reoperation occurred in 34 (6%), readmission in 109 (20%), and mortality in 8 (1.4%). Hospital stay was shorter for laparoscopic DP.

Conclusion

Use of DP increases in the population, particularly in the elderly, with use of laparoscopic access and an association with a reduced hospital stay.

Cited by (0)

This study was presented at the 13th IHPBA congress, 4–7 September, 2018 in Geneva, Switzerland.