• Masato Ota, Mitsuhiro Asakuma, Kohei Taniguchi, Yuri Ito, Kazumasa Komura, Tomohito Tanaka, Kazuma Yamakawa, Takeshi Ogura, Daisuke Nishioka, Fumitoshi Hirokawa, Kazuhisa Uchiyama, and Sang-Woong Lee.
• Department of General and Gastroenterological Surgery, Osaka Medical and Pharmaceutical University.
• Ann. Surg. 2023 Oct 1; 278 (4): e805e811e805-e811.

ObjectiveThis study aimed to compare the short-term outcomes between laparoscopic and open distal pancreatectomy for lesions of the distal pancreas from a real-world database.BackgroundReports on the benefits of laparoscopic distal pancreatectomy include 2 randomized controlled trials; however, large-scale, real-world data are scarce.MethodsWe analyzed the data of patients undergoing laparoscopic or open distal pancreatectomy for benign or malignant pancreatic tumors from April 2008 to May 2020 from a Japanese nationwide inpatient database. We performed propensity score analyses to compare the inhospital mortality, morbidity, readmission rate, reoperation rate, length of postoperative stay, and medical cost between the 2 groups.ResultsFrom 5502 eligible patients, we created a pseudopopulation of patients undergoing laparoscopic and open distal pancreatectomy using inverse probability of treatment weighting. Laparoscopic distal pancreatectomy was associated with lower inhospital mortality during the period of admission (0.0% vs 0.7%, P <0.001) and within 30 days (0.0% vs 0.2%, P =0.001), incidence of reoperation during the period of admission (0.7% vs 1.7%, P =0.018), postpancreatectomy hemorrhage (0.4% vs 2.0%, P <0.001), ileus (1.1% vs 2.8%, P =0.007), and shorter postoperative length of stay (17 vs 20 d, P <0.001).ConclusionsThe propensity score analysis revealed that laparoscopic distal pancreatectomy was associated with better outcomes than open surgery in terms of inhospital mortality, reoperation rate, postoperative length of stay, and incidence of postoperative complications such as postpancreatectomy hemorrhage and ileus.Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.

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