The superior approach with the stomach roll-up technique improves intraoperative outcomes and facilitates learning laparoscopic distal pancreatectomy: a comparative study between the superior and inferior approach

Takanori Morikawa, Masaharu Ishida, Tatsuyuki Takadate, Tatsuo Hata, Masahiro Iseki, Kei Kawaguchi, Hideo Ohtsuka, Masamichi Mizuma, Hiroki Hayashi, Kei Nakagawa, Fuyuhiko Motoi, Takashi Kamei, Takeshi Naito, Michiaki Unno

研究成果: Article査読

4 被引用数 (Scopus)

抄録

Purpose: We introduced a superior approach and a unique technique to retract the stomach, called the “stomach roll-up technique”, to standardize laparoscopic distal pancreatectomy and increase educational effectiveness. The aim of this study was to evaluate the clinical outcomes of these procedures. Methods: Forty-five patients who underwent laparoscopic distal pancreatectomy by surgeons-in-training between January 2015 and December 2018 were included. Twenty laparoscopic distal pancreatectomies were performed using the inferior approach, and 25 procedures were performed using the superior approach. The stomach roll-up technique was used in all cases. The perioperative outcomes were retrospectively analyzed. Results: Compared with the inferior approach, the superior approach was associated with a significantly shorter operation time (p < 0.001) and lower estimated blood loss (p = 0.011), and these differences were not affected by the exclusion of cases with conversion or concomitant procedures. In the univariate analysis adjusted for other covariates, a lower body mass index (p = 0.045), pancreatic tail tumor (p = 0.0178) and the superior approach (p = 0.0176) were significantly associated with a shorter operation time. Conclusion: The superior approach with the stomach roll-up technique is simple and will aid in educating surgeons on performing laparoscopic distal pancreatectomy.

本文言語English
ページ(範囲)153-162
ページ数10
ジャーナルSurgery today
50
2
DOI
出版ステータスPublished - 2020 2 1

ASJC Scopus subject areas

  • 外科

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