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Outcome of minimally-invasive versus open pancreatectomies for solid pseudopapillary neoplasms of the pancreas: A 2:1 matched case-control study
Ann Hepatobiliary Pancreat Surg 2019 Aug;23(3):252-7
Published online August 31, 2019;  https://doi.org/10.14701/ahbps.2019.23.3.252
Copyright © 2019 Korean Association of Hepato-Biliary-Pancreatic Surgery.

Hwee Leong Tan, Ek Khoon Tan, Jin Yao Teo, Juinn Huar Kam, Ser Yee Lee, Peng Chung Cheow, Prema Raj Jeyaraj, Pierce K. Chow, Alexander Y. Chung, London L. Ooi, Chung Yip Chan, and Brian K. P. Goh

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore
Received February 7, 2019; Revised March 25, 2019; Accepted March 29, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Backgrounds/Aims: Solid pseudopapillary neoplasm (SPPN) is typically seen in young healthy females who would likely benefit from minimally-invasive pancreatectomy (MIP). A few comparative studies have suggested that MIP is associated with favorable outcomes when compared to the open approach for SPPN. This study aims to mitigate potential selection bias by performing a matched case-control study comparing MIP vs open pancreatectomy (OP) for SPPN.
Methods: We performed a single-institution retrospective electronic chart review of all patients who underwent surgery for pathologically confirmed SPPN between 2000 and 2017. A 2:1 matched comparison using age, gender, tumor size and the type of pancreatectomy was performed between OP and MIP.
Results: A total of 40 patients with a median age of 40.3 years (range 16.5-64.4) and female sex predominance (n=34, 85.0%) underwent surgery during the study period. Nine patients underwent MIP. Matched comparison between 18 OP and 9 MIP demonstrated that MIP was associated with a longer median operating time (305 vs 180 min, p=0.046) and shorter median postoperative stay (6 vs 9 days, p=0.015). There were no significant differences in intraoperative blood loss, blood transfusion requirements, postoperative morbidity (including postoperative pancreatic fistula) and mortality, resection margins, lymph node yield and long-term survival.
Conclusions: MIP is a safe and viable option in the management of SPPN with the benefit of a shorter postoperative length of stay at the expense of a longer operation time. There was no significant difference in oncologic outcomes between both groups of patients.
Keywords : Laparoscopic pancreatectomy; Minimally-invasive pancreatectomy; Robotic pancreatectomy; Solid pseudopapillary neoplasm

 

August 2019, 23 (3)