The superior approach with the stomach roll-up technique improves intraoperative outcomes and facilitates learning laparoscopic distal pancreatectomy: a comparative study between the superior and inferior approach.

Abstract:

PURPOSE:We introduced a superior approach and a unique technique to retract the stomach, called the "stomach roll-up technique", to standardize laparoscopic distal pancreatectomy and increase educational effectiveness. The aim of this study was to evaluate the clinical outcomes of these procedures. METHODS:Forty-five patients who underwent laparoscopic distal pancreatectomy by surgeons-in-training between January 2015 and December 2018 were included. Twenty laparoscopic distal pancreatectomies were performed using the inferior approach, and 25 procedures were performed using the superior approach. The stomach roll-up technique was used in all cases. The perioperative outcomes were retrospectively analyzed. RESULTS:Compared with the inferior approach, the superior approach was associated with a significantly shorter operation time (p < 0.001) and lower estimated blood loss (p = 0.011), and these differences were not affected by the exclusion of cases with conversion or concomitant procedures. In the univariate analysis adjusted for other covariates, a lower body mass index (p = 0.045), pancreatic tail tumor (p = 0.0178) and the superior approach (p = 0.0176) were significantly associated with a shorter operation time. CONCLUSION:The superior approach with the stomach roll-up technique is simple and will aid in educating surgeons on performing laparoscopic distal pancreatectomy.

journal_name

Surg Today

journal_title

Surgery today

authors

Morikawa T,Ishida M,Takadate T,Hata T,Iseki M,Kawaguchi K,Ohtsuka H,Mizuma M,Hayashi H,Nakagawa K,Motoi F,Kamei T,Naitoh T,Unno M

doi

10.1007/s00595-019-01855-0

subject

Has Abstract

pub_date

2020-02-01 00:00:00

pages

153-162

issue

2

eissn

0941-1291

issn

1436-2813

pii

10.1007/s00595-019-01855-0

journal_volume

50

pub_type

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