Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis

Salvatore Buscemi, Marielda D'Ambra, Claudio Ricci, Giovanni Taffurelli, Enrico Lazzarini, Carlo Alberto Pacilio, Francesco Minni, Riccardo Casadei, Salvatore Buscemi

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Background The use of laparoscopic distal pancreatectomy (LDP) increased in the past twenty years but the real diffusion of this technique is still unknown as well as the type of centers (high or low volume) in which this procedure is more frequently performed. Data Source A systematic review was performed to evaluate the frequency of LDP in Italy and to compare indications and results in high volume centers (HVCs) and in low volume centers (LVCs). Results From 95 potentially relevant citations identified, only 5 studies were included. A total of 125 subjects were analyzed, of whom 95 (76.0%) were from HVCs and 30 (24.0%) from LVCs. The mean number of LDPs performed per year was 6.5. The mean number of patients who underwent LDP per year was 8.8 in HVCs and 3.0 in LVCs (P<0.001). The most frequent lesions operated on in HVCs were cystic tumors (62.1%, P<0.001) while, in LVCs, solid neoplasms (76.7%, P<0.001). In HVCs, malignant neoplasms were treated with LDP less frequently than in LVCs (17.9% vs 50.0%, P<0.001). Splenectomy was performed for non-oncologic reason frequenter in HVCs than in LVCs (70.2% vs 25.0%, P=0.004). The length of stay was shorter in HVCs than in LVCs (7.5 vs 11.3, P<0.001). No differences were found regarding age, gender, ductal adenocarcinoma treated, operative time, conversion, morbidity, postoperative pancreatic fistula, reoperation and margin status. Conclusions LDPs were frequently performed in Italy. The "HVC approach" is characterized by a careful selection of patients undergoing LDP. The "LVC approach" is based on the hypothesis that LDPs are equivalent both in short-term and long-term results to laparotomic approach. These data are not conclusive and they point out the need for a national register of laparoscopic pancreatectomy.
Original languageEnglish
Pages (from-to)458-463
Number of pages6
JournalHEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL
Volume13
Publication statusPublished - 2014

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Pancreatectomy
Italy
Meta-Analysis
Pancreatic Fistula
Neoplasms
Information Storage and Retrieval
Splenectomy
Operative Time
Reoperation
Patient Selection
Length of Stay
Adenocarcinoma
Morbidity

All Science Journal Classification (ASJC) codes

  • Gastroenterology
  • Hepatology
  • Medicine(all)

Cite this

Buscemi, S., D'Ambra, M., Ricci, C., Taffurelli, G., Lazzarini, E., Pacilio, C. A., ... Buscemi, S. (2014). Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis. HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL, 13, 458-463.

Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis. / Buscemi, Salvatore; D'Ambra, Marielda; Ricci, Claudio; Taffurelli, Giovanni; Lazzarini, Enrico; Pacilio, Carlo Alberto; Minni, Francesco; Casadei, Riccardo; Buscemi, Salvatore.

In: HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL, Vol. 13, 2014, p. 458-463.

Research output: Contribution to journalArticle

Buscemi, S, D'Ambra, M, Ricci, C, Taffurelli, G, Lazzarini, E, Pacilio, CA, Minni, F, Casadei, R & Buscemi, S 2014, 'Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis', HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL, vol. 13, pp. 458-463.
Buscemi, Salvatore ; D'Ambra, Marielda ; Ricci, Claudio ; Taffurelli, Giovanni ; Lazzarini, Enrico ; Pacilio, Carlo Alberto ; Minni, Francesco ; Casadei, Riccardo ; Buscemi, Salvatore. / Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis. In: HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL. 2014 ; Vol. 13. pp. 458-463.
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abstract = "Background The use of laparoscopic distal pancreatectomy (LDP) increased in the past twenty years but the real diffusion of this technique is still unknown as well as the type of centers (high or low volume) in which this procedure is more frequently performed. Data Source A systematic review was performed to evaluate the frequency of LDP in Italy and to compare indications and results in high volume centers (HVCs) and in low volume centers (LVCs). Results From 95 potentially relevant citations identified, only 5 studies were included. A total of 125 subjects were analyzed, of whom 95 (76.0{\%}) were from HVCs and 30 (24.0{\%}) from LVCs. The mean number of LDPs performed per year was 6.5. The mean number of patients who underwent LDP per year was 8.8 in HVCs and 3.0 in LVCs (P<0.001). The most frequent lesions operated on in HVCs were cystic tumors (62.1{\%}, P<0.001) while, in LVCs, solid neoplasms (76.7{\%}, P<0.001). In HVCs, malignant neoplasms were treated with LDP less frequently than in LVCs (17.9{\%} vs 50.0{\%}, P<0.001). Splenectomy was performed for non-oncologic reason frequenter in HVCs than in LVCs (70.2{\%} vs 25.0{\%}, P=0.004). The length of stay was shorter in HVCs than in LVCs (7.5 vs 11.3, P<0.001). No differences were found regarding age, gender, ductal adenocarcinoma treated, operative time, conversion, morbidity, postoperative pancreatic fistula, reoperation and margin status. Conclusions LDPs were frequently performed in Italy. The {"}HVC approach{"} is characterized by a careful selection of patients undergoing LDP. The {"}LVC approach{"} is based on the hypothesis that LDPs are equivalent both in short-term and long-term results to laparotomic approach. These data are not conclusive and they point out the need for a national register of laparoscopic pancreatectomy.",
author = "Salvatore Buscemi and Marielda D'Ambra and Claudio Ricci and Giovanni Taffurelli and Enrico Lazzarini and Pacilio, {Carlo Alberto} and Francesco Minni and Riccardo Casadei and Salvatore Buscemi",
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T1 - Laparoscopic distal pancreatectomy in Italy: A systematic review and meta-analysis

AU - Buscemi, Salvatore

AU - D'Ambra, Marielda

AU - Ricci, Claudio

AU - Taffurelli, Giovanni

AU - Lazzarini, Enrico

AU - Pacilio, Carlo Alberto

AU - Minni, Francesco

AU - Casadei, Riccardo

AU - Buscemi, Salvatore

PY - 2014

Y1 - 2014

N2 - Background The use of laparoscopic distal pancreatectomy (LDP) increased in the past twenty years but the real diffusion of this technique is still unknown as well as the type of centers (high or low volume) in which this procedure is more frequently performed. Data Source A systematic review was performed to evaluate the frequency of LDP in Italy and to compare indications and results in high volume centers (HVCs) and in low volume centers (LVCs). Results From 95 potentially relevant citations identified, only 5 studies were included. A total of 125 subjects were analyzed, of whom 95 (76.0%) were from HVCs and 30 (24.0%) from LVCs. The mean number of LDPs performed per year was 6.5. The mean number of patients who underwent LDP per year was 8.8 in HVCs and 3.0 in LVCs (P<0.001). The most frequent lesions operated on in HVCs were cystic tumors (62.1%, P<0.001) while, in LVCs, solid neoplasms (76.7%, P<0.001). In HVCs, malignant neoplasms were treated with LDP less frequently than in LVCs (17.9% vs 50.0%, P<0.001). Splenectomy was performed for non-oncologic reason frequenter in HVCs than in LVCs (70.2% vs 25.0%, P=0.004). The length of stay was shorter in HVCs than in LVCs (7.5 vs 11.3, P<0.001). No differences were found regarding age, gender, ductal adenocarcinoma treated, operative time, conversion, morbidity, postoperative pancreatic fistula, reoperation and margin status. Conclusions LDPs were frequently performed in Italy. The "HVC approach" is characterized by a careful selection of patients undergoing LDP. The "LVC approach" is based on the hypothesis that LDPs are equivalent both in short-term and long-term results to laparotomic approach. These data are not conclusive and they point out the need for a national register of laparoscopic pancreatectomy.

AB - Background The use of laparoscopic distal pancreatectomy (LDP) increased in the past twenty years but the real diffusion of this technique is still unknown as well as the type of centers (high or low volume) in which this procedure is more frequently performed. Data Source A systematic review was performed to evaluate the frequency of LDP in Italy and to compare indications and results in high volume centers (HVCs) and in low volume centers (LVCs). Results From 95 potentially relevant citations identified, only 5 studies were included. A total of 125 subjects were analyzed, of whom 95 (76.0%) were from HVCs and 30 (24.0%) from LVCs. The mean number of LDPs performed per year was 6.5. The mean number of patients who underwent LDP per year was 8.8 in HVCs and 3.0 in LVCs (P<0.001). The most frequent lesions operated on in HVCs were cystic tumors (62.1%, P<0.001) while, in LVCs, solid neoplasms (76.7%, P<0.001). In HVCs, malignant neoplasms were treated with LDP less frequently than in LVCs (17.9% vs 50.0%, P<0.001). Splenectomy was performed for non-oncologic reason frequenter in HVCs than in LVCs (70.2% vs 25.0%, P=0.004). The length of stay was shorter in HVCs than in LVCs (7.5 vs 11.3, P<0.001). No differences were found regarding age, gender, ductal adenocarcinoma treated, operative time, conversion, morbidity, postoperative pancreatic fistula, reoperation and margin status. Conclusions LDPs were frequently performed in Italy. The "HVC approach" is characterized by a careful selection of patients undergoing LDP. The "LVC approach" is based on the hypothesis that LDPs are equivalent both in short-term and long-term results to laparotomic approach. These data are not conclusive and they point out the need for a national register of laparoscopic pancreatectomy.

UR - http://hdl.handle.net/10447/245547

UR - http://www.hbpdint.com/

M3 - Article

VL - 13

SP - 458

EP - 463

JO - HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL

JF - HEPATOBILIARY &amp; PANCREATIC DISEASES INTERNATIONAL

SN - 1499-3872

ER -