Updated outcomes using clockwise technique for laparoscopic distal pancreatectomy:Optimal treatment of benign and malignant disease of the left pancreas

作     者：Jordan S.Dutcher Domenech Asbun Mary P.Tice Horacio J.Asbun John A.Stauffer Jordan S.Dutcher;Domenech Asbun;Mary P.Tice;Horacio J.Asbun;John A.Stauffer

作者机构：Mayo Clinic Alix School of MedicineJacksonvilleFLUSA Department of General SurgeryMayo Clinic FloridaJacksonvilleFLUSA Hepatobiliary and Pancreas SurgeryMiami Cancer InstituteMiamiFLUSA 

出 版 物：《Laparoscopic, Endoscopic and Robotic Surgery》 (腔镜、内镜与机器人外科（英文）)

年 卷 期：2021年第4卷第1期

页      面：9-13页

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Laparoscopic distal pancreatectomy Pancreatic ductal adenocarcinoma Outcomes 

摘      要：Background:Laparoscopic distal pancreatectomy(LDP)has become the preferred approach for surgical management of left sided pancreas *** institution previously published its experience with distal pancreatectomies using a clockwise technique with good *** now reexamine our outcomes across a longer time ***:From August 2008 to November 2020,364 patients underwent LDP by hepatobiliary surgeons(HA and JS).All procedures were performed using the same clockwise approach,which includes the stepwise slow compression *** descriptive analysis of patient demographic,clinical,operative,and pathologic data was ***:Of the 364 patients who underwent LDP using this technique,clinically significant postoperative pancreatic fistula(POPF)was noted in 26(7.1%)patients,while major morbidity and mortality were reported in 9.9%and 0.3%,***-assisted method was required for 18(4.9%)patients and unplanned conversion in 20(5.5%)*** a subset analysis of patients with pancreatic adenocarcinoma(n¼90),POPF was noted in 13(14.4%),with minor complications occurring in 34.4%and major morbidity in 14.4%.Conclusion:LDP with a clockwise approach for dissection,combined with the stepwise slow compression technique results in excellent outcomes,with even lower POPF rates than originally *** analysis of patients with pancreatic adenocarcinoma shows acceptable perioperative outcomes with this technique.