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Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score‐matching
Author(s) -
Nakamura Masafumi,
Wakabayashi Go,
Miyasaka Yoshihiro,
Tanaka Masao,
Morikawa Takanori,
Unno Michiaki,
Tajima Hiroshi,
Kumamoto Yusuke,
Satoi Sohei,
Kwon Masanori,
Toyama Hirochika,
Ku Yonson,
Yoshitomi Hideyuki,
Nara Satoshi,
Shimada Kazuaki,
Yokoyama Takahide,
Miyagawa Shinichi,
Toyama Yoichi,
Yanaga Katsuhiko,
Fujii Tsutomu,
Kodera Yasuhiro,
Tomiyama Yasuyuki,
Miyata Hiroaki,
Takahara Takeshi,
Beppu Toru,
Yamaue Hiroki,
Miyazaki Masaru,
Takada Tadahiro
Publication year - 2015
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.268
Subject(s) - medicine , propensity score matching , perioperative , pancreatic fistula , distal pancreatectomy , pancreatectomy , surgery , laparoscopy , general surgery , pancreas , resection
Background Laparoscopic distal pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta‐analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open distal pancreatectomy using propensity score‐matching. Methods We retrospectively collected perioperative data of 2,266 patients who underwent distal pancreatectomy in 69 institutes from 2006–2013 in Japan. Among them, 2,010 patients were enrolled in this study and divided into two groups, laparoscopic distal pancreatectomy and open distal pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. Results After propensity score‐matching, laparoscopic distal pancreatectomy was associated with favorable perioperative outcomes compared with open distal pancreatectomy, including higher rate of preservation of spleen and splenic vessels ( P < 0.001); lower rates of intraoperative transfusion ( P = 0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P < 0.001), and morbidity ( P < 0.001); and shorter hospital stay ( P = 0.001), but a longer operative time ( P < 0.001). Conclusions Laparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.