Factors associated with and consequences of open conversion after laparoscopic distal pancreatectomy: initial experience at a single institution

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Laparoscopic distal pancreatectomy (LDP) was first reported in 1996 by Gagner.1 Since then, it has been increasingly adopted world‐wide and numerous retrospective studies have confirmed that LDP was associated with the usual advantages reported with other laparoscopic procedures such as shorter hospitalization, more rapid convalescence, less blood loss and decreased analgesia requirements2 compared to the open approach. The postoperative morbidity and pancreatic fistula rate have been shown to be comparable between both approaches.6 Nonetheless, it is important to note that despite the increasing widespread use of this approach, LDP remains a technically challenging procedure as evidenced by the high open conversion rates of 16–31% reported even from high‐volume specialized centers4 especially during the learning phase. Because of these challenges, some surgeons have adopted robotic‐assisted LDP to shorten the learning curve and improve operative outcomes.4
Presently, there is limited data in the literature reporting on the factors predicting conversion and the outcomes after open conversion for patients undergoing LDP.4 Hence, we conducted this study with the primary aim to determine the factors associated with and the consequences of open conversion after LDP during our initial experience with LDP in a tertiary hepatobiliary and pancreatic surgery center.

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