Assessing the impact of conversion on outcomes of minimally invasive distal pancreatectomy and pancreatoduodenectomy

Joal D. Beane, Henry A. Pitt, Scott C. Dolejs, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background: Our aim was to compare outcomes of patients who undergo conversion to open during minimally invasive distal pancreatectomy (MI-DP) and pancreatoduodenectomy (MI-PD) to those completed in minimally invasive fashion, and to compare outcomes of minimally invasive completions and conversions to planned open pancreatectomy. Methods: Propensity scoring was used to compare outcomes of completed and converted cases from a national cohort, and multivariate regression analysis (MVA) was used to compare minimally invasive completions and conversions to planned open pancreatectomy. Results: MI-DP was performed in 43.0%. Conversions (20.2%) had increased morbidity (32.3 vs 42.0%), serious morbidity (11.1 vs 21.2%), and organ space infection (6.2 vs 14.2%). Outcomes of MI-DP conversions were comparable to open. MI-PD was performed in 6.1%. Conversions (25.2%) had increased organ space infection (10.9 vs 26.6%), blood transfusions (17.2 vs 42.2%), and clinically relevant pancreatic fistula (11.5 vs 28.1%). On MVA, conversion of MI-PD was associated with increased mortality (OR 2.84, 95% CI 1.09–7.42), post-operative percutaneous drain placement (OR 2.36, 95% CI 1.32–4.20), and blood transfusions (OR 1.85, 95% CI 1.07–3.21). Conclusion: Converted cases have increased morbidity compared to completions, and for patients undergoing PD, conversions may be associated with inferior outcomes compared to planned open cases.

Original languageEnglish (US)
Pages (from-to)356-363
Number of pages8
JournalHPB
Volume20
Issue number4
DOIs
StatePublished - Apr 2018
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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