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Masafumi Nakamura - One of the best experts on this subject based on the ideXlab platform.
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multicenter comparative study of laparoscopic and open Distal Pancreatectomy using propensity score matching
Journal of Hepato-biliary-pancreatic Sciences, 2015Co-Authors: Masafumi Nakamura, Masao Tanaka, Go Wakabayashi, Yoshihiro Miyasaka, Takanori Morikawa, Michiaki Unno, Hiroshi Tajima, Yusuke Kumamoto, Sohei Satoi, Masanori KwonAbstract:Background Laparoscopic Distal Pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open Distal Pancreatectomy using propensity score-matching. Methods We retrospectively collected perioperative data of 2,266 patients who underwent DistalPancreatectomyin69institutesfrom2006–2013inJapan.Amongthem,2,010patients were enrolled in this study and divided into two groups, laparoscopic Distal Pancreatectomy and open Distal Pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. Results After propensity score-matching, laparoscopic Distal Pancreatectomy was associated with favorable perioperative outcomes compared with open Distal Pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P<0.001); lower rates of intraoperative transfusion (P=0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P<0.001), and morbidity (P<0.001); and shorter hospital stay (P=0.001), but a longer operative time (P<0.001). Conclusions Laparoscopic Distal Pancreatectomy was associated with more favorable perioperative outcomes than open Distal Pancreatectomy.
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laparoscopic Distal Pancreatectomy and pancreatoduodenectomy is it worthwhile a meta analysis of laparoscopic Pancreatectomy
Journal of Hepato-biliary-pancreatic Sciences, 2013Co-Authors: Masafumi Nakamura, Hiroshi NakashimaAbstract:Background/purpose This study was performed to evaluate the outcomes of laparoscopic Distal Pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD) compared with the open method using meta-analysis.
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prolonged peri firing compression with a linear stapler prevents pancreatic fistula in laparoscopic Distal Pancreatectomy
Surgical Endoscopy and Other Interventional Techniques, 2011Co-Authors: Masafumi Nakamura, Junji Ueda, Shunichi Takahata, Hiroshi Kohno, Shuji Shimizu, Mohamed Yahia F Aly, Masao TanakaAbstract:Laparoscopic Distal Pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic Distal Pancreatectomy. Incidence of pancreatic fistula in clinical levels (equivalent to grades B and C defined by the International Study Group of Pancreatic Fistula (ISGPF)) was retrospectively compared between patients who underwent Lap-DP with PFC (PFC group, n = 17) and those who underwent Lap-DP without PFC (no-PFC group, n = 25). Incidence of clinical pancreatic fistula was significantly lower in the PFC group than in the no-PFC group. Consistent with the results for pancreatic fistula, peritoneal drainage period and postoperative hospital stay were shorter in the PFC group than in the no-PFC group. Our data show that PFC effectively prevents pancreatic fistula and shortens postoperative hospital stay after Lap-DP.
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prolonged peri firing compression with a linear stapler prevents pancreatic fistula in laparoscopic Distal Pancreatectomy
Surgical Endoscopy and Other Interventional Techniques, 2011Co-Authors: Masafumi Nakamura, Junji Ueda, Shunichi Takahata, Hiroshi Kohno, Shuji Shimizu, Masao TanakaAbstract:Background Laparoscopic Distal Pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic Distal Pancreatectomy.
Masao Tanaka - One of the best experts on this subject based on the ideXlab platform.
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multicenter comparative study of laparoscopic and open Distal Pancreatectomy using propensity score matching
Journal of Hepato-biliary-pancreatic Sciences, 2015Co-Authors: Masafumi Nakamura, Masao Tanaka, Go Wakabayashi, Yoshihiro Miyasaka, Takanori Morikawa, Michiaki Unno, Hiroshi Tajima, Yusuke Kumamoto, Sohei Satoi, Masanori KwonAbstract:Background Laparoscopic Distal Pancreatectomy has been shown to be associated with favorable postoperative outcomes using meta-analysis. However, there have been no randomized controlled studies yet. This study aimed to compare laparoscopic and open Distal Pancreatectomy using propensity score-matching. Methods We retrospectively collected perioperative data of 2,266 patients who underwent DistalPancreatectomyin69institutesfrom2006–2013inJapan.Amongthem,2,010patients were enrolled in this study and divided into two groups, laparoscopic Distal Pancreatectomy and open Distal Pancreatectomy. Perioperative outcomes were compared between the groups using unmatched and propensity matched analysis. Results After propensity score-matching, laparoscopic Distal Pancreatectomy was associated with favorable perioperative outcomes compared with open Distal Pancreatectomy, including higher rate of preservation of spleen and splenic vessels (P<0.001); lower rates of intraoperative transfusion (P=0.020), clinical grade of pancreatic fistula (International Study Group on Pancreatic Fistula grade B and C; P<0.001), and morbidity (P<0.001); and shorter hospital stay (P=0.001), but a longer operative time (P<0.001). Conclusions Laparoscopic Distal Pancreatectomy was associated with more favorable perioperative outcomes than open Distal Pancreatectomy.
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prolonged peri firing compression with a linear stapler prevents pancreatic fistula in laparoscopic Distal Pancreatectomy
Surgical Endoscopy and Other Interventional Techniques, 2011Co-Authors: Masafumi Nakamura, Junji Ueda, Shunichi Takahata, Hiroshi Kohno, Shuji Shimizu, Mohamed Yahia F Aly, Masao TanakaAbstract:Laparoscopic Distal Pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic Distal Pancreatectomy. Incidence of pancreatic fistula in clinical levels (equivalent to grades B and C defined by the International Study Group of Pancreatic Fistula (ISGPF)) was retrospectively compared between patients who underwent Lap-DP with PFC (PFC group, n = 17) and those who underwent Lap-DP without PFC (no-PFC group, n = 25). Incidence of clinical pancreatic fistula was significantly lower in the PFC group than in the no-PFC group. Consistent with the results for pancreatic fistula, peritoneal drainage period and postoperative hospital stay were shorter in the PFC group than in the no-PFC group. Our data show that PFC effectively prevents pancreatic fistula and shortens postoperative hospital stay after Lap-DP.
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prolonged peri firing compression with a linear stapler prevents pancreatic fistula in laparoscopic Distal Pancreatectomy
Surgical Endoscopy and Other Interventional Techniques, 2011Co-Authors: Masafumi Nakamura, Junji Ueda, Shunichi Takahata, Hiroshi Kohno, Shuji Shimizu, Masao TanakaAbstract:Background Laparoscopic Distal Pancreatectomy (Lap-DP) is one of the most accepted laparoscopic procedures in the field of pancreatic surgery. However, pancreatic fistula remains a major and frequent complication in Lap-DP, as in open surgery. The aim of this retrospective study is to clarify the advantages of prolonged peri-firing compression (PFC) with a linear stapler for prevention of pancreatic fistula after laparoscopic Distal Pancreatectomy.
Wataru Kimura - One of the best experts on this subject based on the ideXlab platform.
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spleen preserving Distal Pancreatectomy with conservation of the splenic artery and vein techniques and its significance
Journal of Hepato-biliary-pancreatic Sciences, 2010Co-Authors: Wataru Kimura, Mitsuhiro Yano, Shuichiro Sugawara, Shinji Okazaki, Tamie Sato, Toshiyuki Moriya, Toshihiro Watanabe, Hiroto Fujimoto, Koji Tezuka, Akiko TakeshitaAbstract:Background Preservation of the spleen in Distal Pancreatectomy has recently attracted considerable attention. Since our first trial and success with spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein for tumors of the pancreas and chronic pancreatitis, this procedure (Kimura’s procedure) has been performed very frequently.
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Spleen-preserving Distal Pancreatectomy for intraductal papillary-mucinous tumor (IPMT).
Hepato-gastroenterology, 2004Co-Authors: Wataru Kimura, Akira Fuse, Ichirou Hirai, Koichi SutoAbstract:BACKGROUND/AIMS Recently, the significance of preserving the spleen has received a lot of attention. Since our first trial and success of spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein for chronic pancreatitis, this procedure has been more frequently performed and reported. In this study, we introduce the technique and indications for the procedure for intraductal papillary mucinous tumor of the pancreas. METHODOLOGY Nine patients underwent spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein. We performed this procedure in two patients with intraductal papillary mucinous tumor. The splenic vein is identified behind the pancreas and within the thin connective tissue membrane. The connective tissue membrane is cut longitudinally above the splenic vein. An important technique is to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen. There are many branches from the splenic vein on both sides, and these branches should be carefully ligated and cut. The pancreas is removed from the splenic artery from the spleen toward the head of the pancreas. This procedure is much easier than removing the pancreas from the vein. RESULTS The postoperative course was uneventful in all nine cases, but one, in which pancreatic fistula continued for more than several weeks. The mean and standard deviation of the operative blood loss, the duration of the operation and the postoperative hospital stay in seven cases, excluding two cases, in which either Puestow's procedure or simultaneous subtotal esophagectomy was performed, were 413+/-385 mL, 298+/-55 min, and 39+/-15 days, respectively. Severe complications were not found in any of the nine cases. The two patients with intraductal papillary mucinous tumor have been followed as outpatients without any recurrence. CONCLUSIONS Spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein is easy and safe, and should be performed for some of the patients with intraductal papillary mucinous tumor of the pancreas.
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spleen preserving Distal Pancreatectomy with preservation of the splenic artery and vein for intraductal papillary mucinous tumor ipmt three interesting cases
Hepato-gastroenterology, 2003Co-Authors: Wataru Kimura, Akira Fuse, Koichi Suto, Toshiyuki Moriya, Ichiro Hirai, Akihiko Suzuki, Fumiaki SakuraiAbstract:Preservation of the spleen at Distal Pancreatectomy has recently attracted considerable attention. Since our first trial and success with spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein for tumors of the pancreas and chronic pancreatitis, this procedure has been performed more frequently. Three patients with intraductal papillary-mucinous tumor underwent spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein. In this procedure, the splenic vein is identified behind the pancreas and the connective tissue membrane is cut longitudinally above the splenic vein. An important point is to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen. In one patient with intraductal papillary-mucinous tumor in the body of the pancreas who had undergone Distal gastrectomy for duodenal ulcer 32 years previously, residual proximal gastrectomy could be avoided with this procedure. In this case, the histological diagnosis was a pseudocyst, and epithelial dysplasia was found in other pancreatic ductuli. In another case, epithelia were borderline between hyperplasia and adenoma. In both of these cases, the histological diagnosis was different from the preoperative diagnosis. Even with advances in imaging techniques, diagnosis of a cystic lesion of the pancreas is still very difficult. Ordinary Distal Pancreatectomy with splenectomy would have been oversurgery in these two cases, which could be avoided using our procedure. Severe complications were not found in any of the three cases and the postoperative course was uneventful. The patients have been followed as outpatients without any recurrence. Spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein is easy and safe, and should be performed for some patients with intraductal papillary mucinous tumor of the pancreas.
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spleen preserving Distal Pancreatectomy with conservation of the splenic artery and vein
Surgery, 1996Co-Authors: Wataru Kimura, Tomomi Inoue, Noriaki Futakawa, Hiroshi Shinkai, Tetsuichiro MutoAbstract:Background. The significance of preserving the spleen has recently been shown. However, there are few reports of spleen-preserving Distal Pancreatectomy for lesions of the body and tail of the pancreas, and this procedure is not generally performed. The aim of this study was to clarify the technique and indications for spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein for benign lesions of the Distal pancreas. Methods. Four patients (two each with an endocrine tumor and a cystic lesion) underwent the procedure. We also performed the spleen-preserving Puestow's procedure with removal of the tail of the pancreas in a 22-year-old male patient with familial chronic pancreatitis. An important technique is to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen and to remove the splenic artery from the pancreas in the other direction. The splenic vein is identified behind the pancreas and within the thin connective tissue membrane, which is cut longitudinally above the splenic vein. It is important to remove the splenic vein from the pancreas from the body of the pancreas toward the spleen, because it is very difficult to remove it in the other direction. There are many branches from the splenic vein on both sides; these branches should be carefully ligated and cut. The pancreas is removed from the splenic artery from the spleen toward the head of the pancreas. This procedure is much easier than removal of the pancreas from the vein. Results. The postoperative course was uneventful in four of the five patients. A pancreatic fistula remained in one patient for several weeks. The mean and standard deviation of the operative blood loss, the duration of the operation, and the postoperative hospital stay in the four uneventful cases, excluding the one in which Puestow's procedure was performed, were 600±479 ml, 290±48 minutes, and 40±21 days, respectively. No severe complications occurred in any of the five patients. Conclusions. Spleen-preserving Distal Pancreatectomy with conservation of the splenic artery and vein is easy and safe and should be performed for benign lesions of the Distal pancreas.
J Van Hilst - One of the best experts on this subject based on the ideXlab platform.
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costs and quality of life in a randomized trial comparing minimally invasive and open Distal Pancreatectomy leopard trial
British Journal of Surgery, 2019Co-Authors: J Van Hilst, E Strating, T De Rooij, Freek Daams, S Festen, Groot B Koerkamp, J M Klaase, M Luyer, Marcel G W Dijkgraaf, M G BesselinkAbstract:Background: Minimally invasive Distal Pancreatectomy decreases time to functional recovery compared with open Distal Pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established. Methods: The LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open Distal Pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost–utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year. Results: All 104 patients who had a Distal Pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open Distal Pancreatectomy (mean difference €–427 (95 per cent bias-corrected and accelerated confidence interval €–4700 to 3613; P = 0·839). Laparoscopic Distal Pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75–10) versus 7 (4–8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open Distal Pancreatectomy. Conclusion: Laparoscopic Distal Pancreatectomy was at least as cost-effective as open Distal Pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.
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minimally invasive versus open Distal Pancreatectomy leopard a multicenter patient blinded randomized controlled trial
Annals of Surgery, 2019Co-Authors: T De Rooij, J Van Hilst, Freek Daams, Hjalmar C Van Santvoort, Djamila Boerma, Peter B Van Den Boezem, Ronald M Van Dam, Cees H Dejong, Eino B Van Duyn, Marcel G W DijkgraafAbstract:Objective:This trial followed a structured nationwide training program in minimally invasive Distal Pancreatectomy (MIDP), according to the IDEAL framework for surgical innovation, and aimed to compare time to functional recovery after minimally invasive and open Distal Pancreatectomy (ODP).Backgrou
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minimally invasive versus open Distal Pancreatectomy for ductal adenocarcinoma diploma a pan european propensity score matched study
Annals of Surgery, 2017Co-Authors: J Van Hilst, T De Rooij, Sjors Klompmaker, M Rawashdeh, Francesca Aleotti, Bilal Alsarireh, Adnan Alseidi, Zeeshan Ateeb, Gianpaolo Balzano, Frederik BerrevoetAbstract:Objective:The aim of this study was to compare oncological outcomes after minimally invasive Distal Pancreatectomy (MIDP) with open Distal Pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC).Background:Cohort studies have suggested superior short-term outcomes of MIDP vs. O
Chang Moo Kang - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic extended subtotal Distal Pancreatectomy with resection of both splenic artery and vein
Surgical Endoscopy and Other Interventional Techniques, 2013Co-Authors: Ho Kyoung Hwang, Chang Moo Kang, Woo Jung Lee, Sung Hoon Choi, Jee Ye KimAbstract:Background Spleen-preserving Distal Pancreatectomy can be performed safely and effectively by resecting both splenic vessels (Warshaw procedure) [1, 2, 3, 4]. This simplified spleen-preserving technique might also be applied to minimally invasive Distal Pancreatectomy of benign and borderline malignant tumor [5, 6].
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revisiting vascular patency after spleen preserving laparoscopic Distal Pancreatectomy with conservation of splenic vessels
Surgical Endoscopy and Other Interventional Techniques, 2012Co-Authors: Ho Kyoung Hwang, Young Eun Chung, Chang Moo KangAbstract:Background We evaluated vascular patency and potential changes in preserved spleens after laparoscopic spleen-preserving Distal Pancreatectomy (SPDP) with conservation of both splenic vessels.
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spleen preserving laparoscopic Distal Pancreatectomy with segmental resection of splenic artery in a solid pseudo papillary tumor of the pancreas
Hepato-gastroenterology, 2009Co-Authors: Chang Moo Kang, Woo Jung LeeAbstract:UNLABELLED Laparoscopic Distal Pancreatectomy is suitable for benign and premalignant neoplasms located in the body and tail of the pancreas. In addition, spleen-preservation following Distal Pancreatectomy for benign or low-grade malignant disease is known to be safe. We present a case of 32-year-old female patient with a solid pseudopapillary tumor of the pancreas treated by spleen-preserving laparoscopic Distal Pancreatectomy with segmental resection of the splenic artery and splenic vein intact. She had uneventful postoperative recovery and was discharged on the 6th postoperative day. Follow up Doppler-ultrasound scan showed no evidence of splenic infarction and well-preserved splenic blood flow. CONCLUSIONS The surgical strategy of segmental resection of the splenic artery with intact splenic vein for spleen preservation seems feasible and represents an alternative option for spleen preservation in laparoscopic Distal Pancreatectomy. More clinical experience is required to address the advantages, limitations, and reproducibility of this technique.