Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2012; 18(16): 1959-1967
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1959
Laparoscopic distal pancreatectomy is as safe and feasible as open procedure: A meta-analysis
Kun Xie, Yi-Ping Zhu, Xiao-Wu Xu, Ke Chen, Jia-Fei Yan, Yi-Ping Mou
Kun Xie, Yi-Ping Zhu, Xiao-Wu Xu, Ke Chen, Jia-Fei Yan, Yi-Ping Mou, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, Zhejiang Province, China
Author contributions: Xie K and Zhu YP wrote the manuscript; Xu XW, Chen K and Yan JF collected literatures and conducted the analysis of pooled data; Mou YP proofread and revised the manuscript; all authors approved the version to be published.
Supported by The key project grant from the Science and Technology Department of Zhejiang Province, No. 2011C13036-2
Correspondence to: Yi-Ping Mou, MD, PhD, Professor, Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. mou_yp@yahoo.cn
Telephone: +86-571-86006445 Fax: +86-571-86044817
Received: August 8, 2011
Revised: October 11, 2011
Accepted: January 7, 2012
Published online: April 28, 2012
Abstract

AIM: To evaluate the feasibility and safety of laparoscopic distal pancreatectomy (LDP) compared with open distal pancreatectomy (ODP).

METHODS: Meta-analysis was performed using the databases, including PubMed, the Cochrane Central Register of Controlled Trials, Web of Science and BIOSIS Previews. Articles should contain quantitative data of the comparison of LDP and ODP. Each article was reviewed by two authors. Indices of operative time, spleen-preserving rate, time to fluid intake, ratio of malignant tumors, postoperative hospital stay, incidence rate of pancreatic fistula and overall morbidity rate were analyzed.

RESULTS: Nine articles with 1341 patients who underwent pancreatectomy met the inclusion criteria. LDP was performed in 501 (37.4%) patients, while ODP was performed in 840 (62.6%) patients. There were significant differences in the operative time, time to fluid intake, postoperative hospital stay and spleen-preserving rate between LDP and ODP. There was no difference between the two groups in pancreatic fistula rate [random effects model, risk ratio (RR) 0.996 (0.663, 1.494), P = 0.983, I2 = 28.4%] and overall morbidity rate [random effects model, RR 0.81 (0.596, 1.101), P = 0.178, I2 = 55.6%].

CONCLUSION: LDP has the advantages of shorter hospital stay and operative time, more rapid recovery and higher spleen-preserving rate as compared with ODP.

Keywords: Laparoscopy; Distal pancreatectomy; Pancreatic fistula; Spleen-preserving; Morbidity