Minimally-invasive versus open enucleation for pancreatic tumours: A propensity-score adjusted analysis

Abstract

Backgrounds/Aims: This study aims to evaluate the perioperative outcomes of minimally-invasive enucleation (MIEn) of the pancreas versus open enucleation (OEn). Methods: This is a retrospective review of 20 consecutive patients who underwent pancreatic enucleation at a single institution. Results: Seven patients underwent MIEn, of which 3 were robotic and 4 were laparoscopic. After propensity-adjusted analysis, the only significant difference was a reduced rate of readmissions within 30 days in the MIEn group versus the OEn group [0 vs 4 (30.8%), p=0.0464]. There were no conversions to open in the MIEn group, and median operation time was similar in both groups. There was no difference in median EBL in both groups, and none of the patients in our series required blood transfusions. The overall morbidity rate was 45.0% and the major complication (Clavien-Dindo＞2) rate was 15%; which was similar between both groups. Seven (35%) patients had a Grade B/C POPF, and there was no significant difference between the two groups for this. The MIEn group had a shorter median length of stay compared to OEn [5 days (range, 3-24) vs 8.5 days (range, 5-42)] this was not significant on propensity-adjusted analysis (p=0.3195). There was no post-operative 90-day/ in-hospital mortality in all 20 patients. Conclusions: Our experience demonstrates that MIEn was associated with similar perioperative outcomes and fewer readmissions compared to OEn. (Ann Hepatobiliary Pancreat Surg 2019;23:258-264)