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©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Apr 28, 2012; 18(16): 1959-1967
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1959
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1959
Table 1 Database and search strategy
Database | Search strategy |
PubMed | "laparoscopy" (MeSH terms) or "laparoscopy" (all fields) or "laparoscopic" (all fields) or (minimally (all fields) and invasive (all fields) and ("pancreas" (MeSH terms) or "pancreas" (all fields) or "pancreatic" (all fields) and "humans" (MeSH terms) and English (lang) and "1995/1/1" (PDAT): "2011/06/30" (PDAT) |
Web of Science | "pancreas" or "pancreatic" or "pancreatectomy" and "laparoscopy" or "laparoscopic" (limited year: 1995-2011) |
Cochrane Library | "pancreas" or "pancreatic" or "pancreatectomy" and "laparoscopy" or "laparoscopic" (limited year: 1995-2011) |
BIOSIS Previews | "pancreas" or "pancreatic" or "pancreatectomy" and "laparoscopy" or "laparoscopic" (limited year: 1995-2011) (related term and limited English and human and year: 1995-2011) |
Table 2 Characteristics of the literatures
Ref. | Study year | Nation | Case number | Study type | Pancreatictransection | Spleen persevation | Totalmorbidity | PF | Mortality % | Level of evidence | ||||||
LDP | ODP | LDP | ODP | LDP | ODP | LDP | ODP | LDP | ODP | LDP | ODP | |||||
Aly et al[23] | 1998-2009 | Japan | 40 | 35 | Retro | Stapler | Stapler/scalpel + suture | 13 | 3 | 8 | 11 | 5 | 6 | 0 | 0 | 4 |
Baker et al[24] | 2003-2008 | USA | 27 | 85 | Pros | Stapler/ scalpel + micro sealer device | Scalpel + suture | NA | 10 | 30 | 6 | 12 | 0 | 0 | 2b | |
Butturini et al[25] | 1999-2006 | Italy | 43 | 73 | Retro | Stapler | Scalpel + suture | 19 | 8 | 21 | 33 | 12 | 10 | 0 | 0 | 2b |
Casadei et al[26] | 2000-2010 | Italy | 22 | 22 | Case control | Stapler | Stapler | NA | 6 | 6 | 2 | 4 | 0 | 0 | 2b | |
DiNorcia et al[27] | 1991-2009 | USA | 71 | 192 | Retro | Stapler | Stapler/ Scalpel + suture | 11 | 30 | 20 | 84 | 8 | 27 | 0 | 2 | 4 |
Eom et al[28] | 1995-2006 | Korea | 31 | 62 | Retro | Stapler | Scalpel + suture | 13 | NA | 11 | 15 | 3 | 4 | 0 | 0 | 4 |
Jayaraman et al[29] | 2003-2009 | USA | 74 | 236 | Retro | Stapler/ scalpel + suture | Stapler/ scalpel + suture | 14 | 33 | 11 | 94 | 6 | 31 | NA | 4 | |
Kim et al[30] | NA | Korea | 93 | 35 | Retro | Stapler | Stapler/ Scalpel + suture | 38 | 2 | 23 | 11 | 8 | 5 | NA | 4 | |
Vijan et al[31] | 2004-2009 | USA | 100 | 100 | Retro | Stapler | NA | 25 | NA | 34 | 29 | 17 | 17 | 3 | 1 | 4 |
Table 3 Technical details of spleen-preservation
Ref. | Spleen preserving % | Technical details | |
LDP | ODP | ||
Aly et al[23] | 32.5 | 8.6 | Both procedures, spleen vessel ligation were performed, leaving the short gastric vessels to supply the spleen (Warshaw) |
Baker et al[24] | NA | In ODP, the benign and premalignant pathology, the spleen was routinely saved by means of the splenic vein and artery preserved | |
In LDP, splenic salvage by means of Warshaw: ligating the splenic artery and vein but preserve the short gastric vessel | |||
Butturini et al[25] | 44.2 | 11.0 | Both procedures, exposing the splenic vein up to the splenic hilum; the distal pancreas was detached from the splenic artery in the opposite direction by tractioning the parenchyma |
Casadei et al[26] | NA | Mobilization of the distal pancreas from retroperitoneum and splenic vessels | |
DiNorcia et al[27] | 15.5 | 15.6 | For spleen preserving distal pancreatectomy, an attempt to spare the splenic artery and vein was made in all patients |
Eom et al[28] | 41.9 | NA | For spleen preserving distal pancreatectomy, both the splenic artery and vein were preserved |
Jayaraman et al[29] | 18.9 | 14.0 | When splenic preservation was performed, the splenic vein and artery were isolated |
Kim et al[30] | 40.9 | 5.70 | In spleen preserving distal pancreatectomy, both the splenic artery and vein were preserved. In one case, the splenic artery was ligated with preservation of splenic vein. In the other case, both the splenic artery and vein were ligated, with preservation of short gastric vessels (Warshaw) |
Vijan et al[31] | 25 | NA | If splenic preservation is indicated, the pancreas is dissected off the splenic vessels |
Table 4 Technique of pancreatic stump closure
Ref. | Technique description | |
Aly et al[23] | LDP | The pancreatic parenchyma was transected using a laparoscopic linear stapler |
ODP | The pancreatic parenchyma was transected using a scalpel, and the main pancreatic duct was ligated using nonabsorbable sutures. The pancreatic stump was closed with fish-mouth sutures. A linear stapler was used to transect the pancreatic parenchyma | |
Baker et al[24] | LDP | The gland was divided by one of 3 mechanisms: vascular stapler, harmonic scalpel, or harmonic scalpel following ablation at the pancreatic resection margin with the Habib 4*3 microsealer device |
ODP | Directly ligate the pancreatic duct when visible with a monofilament absorbable suture. The neck of the gland was oversewn with nonabsorbable monofilament suture | |
Butturini et al[25] | LDP | The pancreatic body was transected by a linear endostapler |
ODP | Pancreatic parenchyma was sharply transected. The main pancreatic duct was closed with nonabsorbable sutures (polypropylene 4/0). Subsequently the pancreatic stump was oversewn with interrupted mattress nonabsorbable sutures or closed using a linear stapler | |
Casadei et al[26] | LDP | The pancreas was divided at the neck using an endo-GIA instrument |
ODP | The pancreas was divided using GIA 55 | |
DiNorcia et al[27] | LDP | Sutures, staples, sutures and staples combined, or staples with bioabsorbable staple-line reinforcement |
ODP | ||
Eom et al[28] | LDP | The pancreas was transected using the 48- or 35-mm vascular endoscopic linear stapler |
ODP | The pancreatic parenchyma was divided using a blade and electrocautery. The main pancreatic duct was ligated with nonabsorbable sutures, and the transected pancreas was occluded with interlocking interrupted mattress sutures of 4-0 black silk and reinforced with 4-0 polypropylene | |
Jayaraman et al[29] | LDP | The pancreas was stapled using a vascular stapler with or without a Seamguard attachment |
ODP | Ligate pancreas with staples, or via suture ligation, or a combination of techniques | |
Kim et al[30] | LDP | For pancreatic transaction, straight endoscopic linear staplers of various sizes (staple height, 3.5-4.2 mm) were used according to the thickness or hardness of the pancreas. Four or five small titanium clips were applied along the stapling line |
ODP | The pancreatic stump underwent main duct ligation, multiple suture ligation of the branch duct exposed at the resection margin, and reinforcement of the mattress suture to the pancreas stump | |
Vijan et al[31] | LDP | The pancreatic parenchyma is divided with the harmonic scalpel (preferred) or with an Endo GIA stapler |
ODP | NA |
- Citation: Xie K, Zhu YP, Xu XW, Chen K, Yan JF, Mou YP. Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: A meta-analysis. World J Gastroenterol 2012; 18(16): 1959-1967
- URL: https://www.wjgnet.com/1007-9327/full/v18/i16/1959.htm
- DOI: https://dx.doi.org/10.3748/wjg.v18.i16.1959