A comparative study between minimally invasive and traditional open surgery in treating patients with pancreatic body or tail lesions

Objective To study the feasibility, safety, indications and possible advantages of minimally invasive surgery over traditional open surgery in treating pancreatic body or tail lesions. Methods From December 2009 to December 2014, the clinical data of 71 patients with lesions in pancreatic body or tail who underwent minimally invasive distal pancreatectomy (MIDP) or open distal pancreatectomy (ODP) at the General Surgery of Huadong Hospital were retrospectively analyzed. There were 22 patients in the MIDP group and 49 patients in the ODP group. The operations in 15 patients in the MIDP group were performed by the Da Vinci robot-assisted surgical system and 7 patients by laparoscopic distal pancreatectomy. Results The MIDP group had a shorter time to pass first flatus [(MIDP (2.5±1.0)d vs ODP (3.5±1.0)d, P 0.05] and symptomatic postoperative pancreatic fistula rate [MIDP 18.2% (4/22) vs ODP 18.4% (9/49), P>0.05] between the two groups. The MIDP group had a significant longer operative time [MIDP (246.3±75.3)min vs ODP (168.1±33.7)min, P<0.05] than the ODP group. Conclusions Minimally invasive surgery is safe and feasible in treatment of lesions in pancreatic body or tail with less trauma and faster recovery. The application of robotic surgery has expanded the treatment options for lesions in pancreatic body or tail. Key words: Robotic surgery; Laparoscopic surgery; Pancreatectomy; Pancreatic lesions; Therapy; Minimal invasion