• Masafumi Nakamura, Go Wakabayashi, Yoshihiro Miyasaka, Masao Tanaka, Takanori Morikawa, Michiaki Unno, Hiroshi Tajima, Yusuke Kumamoto, Sohei Satoi, Masanori Kwon, Hirochika Toyama, Yonson Ku, Hideyuki Yoshitomi, Satoshi Nara, Kazuaki Shimada, Takahide Yokoyama, Shinichi Miyagawa, Yoichi Toyama, Katsuhiko Yanaga, Tsutomu Fujii, Yasuhiro Kodera, Study Group of JHBPS, JSEPS, Yasuyuki Tomiyama, Hiroaki Miyata, Takeshi Takahara, Toru Beppu, Hiroki Yamaue, Masaru Miyazaki, and Tadahiro Takada.
• Department of Digestive Surgery, Kawasaki Medical School, Kurashiki, Japan.
• J Hepatobiliary Pancreat Sci. 2015 Oct 1; 22 (10): 731-6.

BackgroundLaparoscopic 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.MethodsWe 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.ResultsAfter 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).ConclusionsLaparoscopic distal pancreatectomy was associated with more favorable perioperative outcomes than open distal pancreatectomy.© 2015 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

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