Advantage of Postoperative Inflammatory Status after Laparoscopic Distal Pancreatectomy

Dig Surg. 2024;41(5-6):213-223. doi: 10.1159/000541449. Epub 2024 Oct 9.

Abstract

Introduction: Laparoscopic distal pancreatectomy (LDP) is a safe and effective procedure; however, its impact on perioperative inflammatory reactions compared with open distal pancreatectomy (ODP) remains unclear. This study aimed to assess short-term outcomes following LDP and ODP regarding inflammatory reactions.

Methods: This retrospective study of 77 consecutive patients who underwent distal pancreatectomy for low-grade malignancies between 2005 and 2022 compared white blood cell (WBC) count, C-reactive protein (CRP) level, serum albumin level, and CRP/albumin ratio (CAR) between LDP and ODP. Complications, especially postoperative pancreatic fistula (POPF), recovery program, and hospital stay period, were also compared.

Results: POPF (17.1% vs. 38.7%, p = 0.039) and surgical morbidity (≥Clavien-Dindo grade III, 12.2% vs. 32.3%, p = 0.038) were significantly lower in LDP than in ODP, as for the difference in postoperative inflammatory response, including CRP and CAR, was just temporary. By multivariate analysis, CAR ≥6.94 on POD 3 was significant predictor of POPF (42.1% vs. 13.2%, odds ratio 4.828, p = 0.030).

Conclusion: LDP has lower POPF and earlier postoperative recovery. CAR could be a predictor of POPF.

Keywords: Inflammatory response; Laparoscopy; Pancreatectomy.

MeSH terms

  • Adult
  • Aged
  • C-Reactive Protein* / analysis
  • C-Reactive Protein* / metabolism
  • Female
  • Humans
  • Inflammation* / blood
  • Inflammation* / etiology
  • Laparoscopy* / adverse effects
  • Length of Stay
  • Leukocyte Count
  • Male
  • Middle Aged
  • Pancreatectomy* / adverse effects
  • Pancreatectomy* / methods
  • Pancreatic Fistula* / etiology
  • Pancreatic Neoplasms* / blood
  • Pancreatic Neoplasms* / surgery
  • Postoperative Complications* / blood
  • Postoperative Complications* / etiology
  • Retrospective Studies
  • Serum Albumin / analysis

Substances

  • C-Reactive Protein
  • Serum Albumin