Laparoscopic resection of pancreatic adenocarcinoma: Dream or reality?

Table 1 Published comparisons of laparoscopic distal pancreatectomy and open distal pancreatectomy with at least five cases of adenocarcinoma

Study	Cases		Malignant pathology		Mean node harvest		R0 margins		Mean blood loss (mL)		Mean length of stay (d)		Pancreatic fistula rate		Mortality		Overall morbidity
	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP	LDP	ODP
Rehman et al[35]	8	14	100%	100%	161	141	88%	86%	306	650	8	12	25%	21%	0%	0%	NR	NR
Mehta et al[36]	30	30	23%	23	8	14	NR	NR	294	726	9	13	17%	13%	0%	3%	50%	43%
Limongelli et al[37]	16	29	36%	45%	NR	NR	94%	93%	160	365	6	9	18%	20%	0%	3%	25%	41%
Abu Hilal et al[38]	35	16	19%	11%	NR	NR	75%	67%	200	394	7	11	29%	44%	0%	6%	40%	69%
DiNorcia et al[39]	71	168	13%	39%	6	8	97%	87%	150	900	5	6	11%	14%	0%	1%	28%	44%
Vijan et al[40]	100	100	23%	23%	NR	NR	0%	0	171	519	6	9	17%	17%	3%	1%	34%	29%
Kooby et al[41]	23	189	100%	100%	14	12	73%	74%	422	790	7	11	NR	NR	0%	1%	NR	NR
Jayaraman et al[42]	107	236	17%	47%	6	7	97%	96%	175	300	5	6	15%	13%	0%	1%	26%	33%
Baker et al[43]	27	85	29%	30%	5	9	NR	NR	219	612	4	8	22%	14%	0%	2%	37%	35%
Finan et al[44]	44	98	25%	42%	NR	NR	0%	0%	157	719	6	9	50%	46%	0%	5%	NR	NR
Kooby et al[45]	142	200	36%	49%	NR	NR	92%	93%	357	588	6	9	11%	18%	0%	1%	40%	57%
Eom et al[46]	31	62	10%	7%	NR	NR	NR	NR	NR	NR	12	14	10%	7%	0%	0%	36%	24%
Velanovich[47]	15	15	20%	32%	NR	NR	NR	NR	NR	NR	5	8	13%	13%	0%	0%	20%	27%

¹Median. NR: Not reported; LDP: Laparoscopic distal pancreatectomy; ODP: Open distal pancreatectomy.

Table 2 Definitions of post-operative pancreatic fistulae

Study	Definition of post-operative pancreatic fistula
Rehman et al[35]	ISGPF definition
Mehta et al[36]	ISGPF (grade B and C)
Limongelli et al[37]	ISGPF definition
Abu Hilal et al[38]	ISGPF definition
DiNorcia et al[39]	ISGPF definition
Vijan et al[40]	ISGPF definition
Kooby et al[41]	NR
Jayaraman et al[42]	ISGPF definition
Baker et al[43]	ISGPF definition
Finan et al[44]	ISGPF definition
Kooby et al[45]	ISGPF definition
Eom et al[46]	Drainage > 30 mL with amylase > 600 U/dL
Velanovich[47]	Amylase-rich fluid after POD 3

ISGPF: International Study Group on Pancreatic Fistula; NR: Not reported; POD: Post-operative day.

Table 3 Published series on laparoscopic and robotic pancreaticoduodenectomy with at least five cases of adenocarcinoma (variables reported for entire series, not just malignant cases)

Study	Cases	Malignant pathology	Mean node harvest (range)	R0 margin	Mean blood loss (mL)	Mean length of stay (d)	Pancreatic fistula rate	Mortality	Overall morbidity	Mean operative time (min)
2Bao et al[77]	28	4 AC	15 (8-32)1	63%	1001	7 1	21%	7%	NR	4311
		10 PDAC
Kim et al[78]	100	4 AMP	13 (7-34)	100%	NR	14	6%	1%	25%	487
		7 PDAC
Asbun et al[76]	53	8 AMP	23 (SD 10)	95%	195	8	17%	6%	22%	608
		22 PDAC
2Chalikonda et al[79]	30	14 adeno-carcinoma	13 (1-37)	100%	486	10	7%	3%	30%	476
2Lai et al[80]	20	5 AC	10 (SD 60)	73%	247	14	35%	0%	50%	492
		7 PC
2Zeh et al[81]	50	9 AMP	17 (5-37)	89%	3501	10	20%	2%	30%3	5681
		14 PDAC
Suzuki et al[72]	6	4 AMP	18 (16-27)	100%	4711	231	33%	0%	33%	5811
		1 PDAC
Ammori et al[15]	7	2 AMP	20.8 (11-32)	NR	350	11	14%	0%	29%	628
		5 PDAC
2Giulianotti et al[82]	60	15 AMP	18 (5-45)	92%	394	22	31%	14%	31%	421
		27 PDAC
Kendrick et al[83]	62	8 AMP	15 (6-31)	89%	240	7	18%	2%	42%	3681
		31 PDAC
Cho et al[66]	15	1 AMP	19 (NR)	100%	445	16	13%	0%	27%	338
		4 PDAC
Palanivelu et al[84]	75	29 AMP	14 (8-22)	97%	74	8	7%	1%	27%	357
		33 PDAC
Pugliese et al[67]	19	4 AMP	12 (4-22)	100%	180	18	23%	0%	37%	461
		6 PDAC
Dulucq et al[75]	25	4 AMP	18 (NR)	100%	107	16	5%	5%	32%	287
		11 PDAC
Staudacher et al[69]	7	1 PDAC	26 (16-47)	100%	325	12	0%	0%	0%	416
Gagner et al[85]	10	3 AMP	7 (3-14)	100%	NR	22	17%	0%	50%	510
		4 PDAC

¹Median;

²Robotic hybrid;

³Clavien III/IV. AC: Ampullary cancer; PDAC: Pancreatic ductal adenocarcinoma; AMP: Ampullary adenocarcinoma/ampullary dysplastic adenoma; NR: Not reported; PC: Pancreatic cancer.