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首页> 外文期刊>Surgical Endoscopy >Laparoscopic distal pancreatectomy: which factors are related to open conversion? Lessons learned from 68 consecutive procedures in a high-volume pancreatic center
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Laparoscopic distal pancreatectomy: which factors are related to open conversion? Lessons learned from 68 consecutive procedures in a high-volume pancreatic center

机译：腹腔镜远端胰切除术：哪些因素与开放转化有关？ 从大批胰中心的68个连续程序中汲取经验教训

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Background Laparoscopic distal pancreatectomy represents a difficult surgical procedure with an high conversion rate to open procedure. The factors related to its difficulty and conversion to open distal pancreatectomy were rarely reported. The aim of the present study was to identify which factors are related to conversion from laparoscopic to open distal pancreatectomy. Methods A retrospective study of a prospective database of 68 patients who underwent laparoscopic distal pancreatectomy was conducted at a high-volume center by pancreatic surgeons experienced with laparoscopic surgery. Pre-intra and postoperative data were collected. Patients who completed a laparoscopic distal pancreatectomy were compared with those who needed a conversion to the open approach as regard demographic, clinical, radiological, and surgical data. Univariate and multivariate analyses were carried out. Results Univariate analysis suggested that the site of the lesion, the extension of pancreatic resection, and the requirement for an extended procedure to adjacent organs were significantly associated with the risk of conversion to the open approach. Multivariate analysis showed that only the extension of the pancreatic resection (subtotal pancreatectomy) was significantly related to the odds of conversion [odds ratio (OR) 19.5; 95% confidence interval (CI) 1.1–32.3; P ?=?0.038]. Preoperative suspicion of malignancy differed between the two groups; however, this difference did not reach statistical significance ( P ?=?0.078). Conclusions Despite the limitations of the study, only the extension of pancreatic resection seemed to be the main factor related to conversion during laparoscopic distal pancreatectomy.
机译：背景技术腹腔镜远端胰切除术代表具有高转化率的难以打开的手术的外科手术。很少报道与其困难和转化为开放的胰腺切除术有关的因素。本研究的目的是确定哪些因素与从腹腔镜转换到从腹腔镜打开远端胰腺切除术有关。方法采用腹腔镜手术经历的胰外科医生进行68例接受腹腔镜远端胰腺切除术的68名患者前瞻性数据库的回顾性研究。收集了前的内部和术后数据。与那些需要转换为开放方法的人进行比较完成腹腔镜远端胰腺切除术的患者，以方便，临床，放射性和手术数据。进行单变量和多变量分析。结果单变量分析表明，病变的部位，胰切除术的延伸，以及对相邻器官的扩展程序的要求与转换为开放方法的风险显着相关。多变量分析表明，只有胰切除术（畸形胰腺切除术）的延伸显着与转化率的几率有关[赔率比（或）19.5; 95％置信区间（CI）1.1-32.3; p？= 0.038]。术前怀疑恶性肿瘤不同于两组;然而，这种差异没有达到统计学意义（P？= 0.078）。结论尽管研究的局限性，但只有胰切除术的延伸似乎是腹腔镜远端胰腺切除术期间与转化有关的主要因素。

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