Laparoscopic resection of the pancreas (LRP) has been implemented to a varying degree because it is technically demanding and requires a long learning curve. In the present study we analyze the risk factors for complications and hospital readmissions in a single center study of 105 consecutive LRPs.
MethodsWe conducted a retrospective study using a prospective database. Data were collected on age, gender, BMI, ASA score, type of surgery, histologic type, operative time, hospital stay, postoperative complications, degree of severity and hospital readmission.
ResultsThe cohort included 105 patients, 63 females and 42 males with a median age and BMI of 58 (53–70) and 25.5 (22,2–27.9) respectively.
Eighteen (17%) central pancreatectomies, 5 (4.8%) enucleations, 81 (77.6%) distal pancreatectomies and one total pancreatectomy were performed.
Fifty-six patients (53.3%) experienced some type of complication, of which 13 (12.3%) were severe (Clavien-Dindo > IIIb) and 11 (10.5%) patients were readmitted in the first 30 days after surgery.
In the univariate analysis, age, male gender, ASA score, central pancreatectomy and operative time were significantly associated with the development of complications (P <0.05). In the multivariate analysis, male gender (OR 7.97; 95% CI 1.08–58.88)), severe complications (OR 59.40; 95% CI, 7.69–458.99), and the development of intrabdominal collections (OR 8.97; 95% CI, 1.28–63.02)) were associated with hospital readmission.
ConclusionsAge, male gender, ASA score, operative time and central pancreatectomy are associated with a higher incidence of complications. Male gender, severe complications and intraabdominal collections are associated with more hospital readmissions.
Las resecciones laparoscópicas del páncreas (RLP) tienen un grado de implantación muy heterogéneo debido a su dificultad técnica y a exigir una curva de aprendizaje larga. En el presente trabajo estudiamos los factores de riesgo de las complicaciones y de los reingresos en una serie unicéntrica de 105 RLP.
MétodosSe realizó un estudio retrospectivo. Se recogieron la edad, sexo, índice de masa corporal, el grado ASA, tipo de cirugía, tipo histológico, duración de la intervención, estancia hospitalaria, las complicaciones postoperatorias, grado de gravedad y reingreso.
ResultadosLa cohorte comprende 105 pacientes, 63 mujeres y 42 varones, con una mediana de edad y IMC, de 58 (53–70) y 25.5 (22.2–25.5) respectivamente.
Se realizaron 18 (17%) pancreatectomias centrales, 81 (77%) distales, 5 (4.8%) enucleaciones y una total.
56 (53.3%) pacientes sufrieron alguna complicación, 13 (12.3%) fueron graves (Clavien-Dindo > IIIb) y hubo 11 (10.5%) reingresos.
En el análisis univariante, la edad, el sexo masculino, el grado ASA, la pancreatectomía central y el tiempo operatorio se asociaban significativamente con el desarrollo de complicaciones (P < 0.05). En el análisis multivariante, los varones (OR 7.97; 95% IC 1.08–58.8), las complicaciones severas (OR 59.40; 95% IC 7.69–458.9), el desarrollo de colecciones intraabdominales (OR 8.97; 95% IC 1.2–63.0) se asociaban con el reingreso hospitalario.
ConclusionesLa edad, el sexo masculino, el grado ASA, la duración de la intervención y la pancreatectomía central se asocian con mayor incidencia de complicaciones. Los varones, las complicaciones graves, las colecciones intraabdominales se asociaban con más reingresos hospitalarios.