Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy

Abstract Aim Decreasing intraoperative blood loss is one reported advantage of laparoscopic surgery compared with open surgery. However, several reports indicate that blood loss during laparoscopic surgery may be underestimated. No studies have evaluated this possibility in laparoscopic distal pancr...

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Main Authors: Keisuke Toya, Yoshito Tomimaru, Shogo Kobayashi, Kazuki Sasaki, Yoshifumi Iwagami, Daisaku Yamada, Takehiro Noda, Hidenori Takahashi, Yuichiro Doki, Hidetoshi Eguchi
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Annals of Gastroenterological Surgery
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Online Access:https://doi.org/10.1002/ags3.12888
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author Keisuke Toya
Yoshito Tomimaru
Shogo Kobayashi
Kazuki Sasaki
Yoshifumi Iwagami
Daisaku Yamada
Takehiro Noda
Hidenori Takahashi
Yuichiro Doki
Hidetoshi Eguchi
author_facet Keisuke Toya
Yoshito Tomimaru
Shogo Kobayashi
Kazuki Sasaki
Yoshifumi Iwagami
Daisaku Yamada
Takehiro Noda
Hidenori Takahashi
Yuichiro Doki
Hidetoshi Eguchi
author_sort Keisuke Toya
collection DOAJ
description Abstract Aim Decreasing intraoperative blood loss is one reported advantage of laparoscopic surgery compared with open surgery. However, several reports indicate that blood loss during laparoscopic surgery may be underestimated. No studies have evaluated this possibility in laparoscopic distal pancreatectomy (LDP). Here we evaluated estimated blood loss (e‐BL) compared to intraoperative blood loss (i‐BL) during distal pancreatectomy (DP). Methods This study included 114 patients undergoing DP in our institution during the study period. We examined the relationship between i‐BL and e‐BL. Based on these results, we further investigated the relationship with LDP. Results The laparoscopic approach was used in a significantly higher percentage of patients in e‐BL > i‐BL group compared to e‐BL < i‐BL group (55.9% vs 10.9%, p < 0.0001). Within the LDP group (n = 39), e‐BL was significantly more than i‐BL (388 ± 248 vs 127 ± 160 mL; p < 0.0001). Within the open distal pancreatectomy (ODP) group (n = 75), e‐BL was significantly less than i‐BL (168 ± 324 vs 281 ± 209 mL; p = 0.0017). The e‐BL > i‐BL trend in the LDP group was consistent, regardless of the indication for DP. In contrast, the finding of i‐BL > e‐BL in the ODP group was limited to patients with pancreatic cancer. Conclusion During LDP, e‐BL was significantly more than i‐BL. During ODP, e‐BL was significantly less than i‐BL, only in patients with pancreatic cancer. These results suggested the possibility of i‐BL underestimation during LDP, and overestimation during ODP in cases with pancreatic cancer.
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spelling doaj-art-1d29b3d12b074a5bb25de9ff654c0e4b2025-08-20T03:49:40ZengWileyAnnals of Gastroenterological Surgery2475-03282025-05-019356957710.1002/ags3.12888Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomyKeisuke Toya0Yoshito Tomimaru1Shogo Kobayashi2Kazuki Sasaki3Yoshifumi Iwagami4Daisaku Yamada5Takehiro Noda6Hidenori Takahashi7Yuichiro Doki8Hidetoshi Eguchi9Department of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanDepartment of Gastroenterological Surgery, Graduate School of Medicine Osaka University Osaka JapanAbstract Aim Decreasing intraoperative blood loss is one reported advantage of laparoscopic surgery compared with open surgery. However, several reports indicate that blood loss during laparoscopic surgery may be underestimated. No studies have evaluated this possibility in laparoscopic distal pancreatectomy (LDP). Here we evaluated estimated blood loss (e‐BL) compared to intraoperative blood loss (i‐BL) during distal pancreatectomy (DP). Methods This study included 114 patients undergoing DP in our institution during the study period. We examined the relationship between i‐BL and e‐BL. Based on these results, we further investigated the relationship with LDP. Results The laparoscopic approach was used in a significantly higher percentage of patients in e‐BL > i‐BL group compared to e‐BL < i‐BL group (55.9% vs 10.9%, p < 0.0001). Within the LDP group (n = 39), e‐BL was significantly more than i‐BL (388 ± 248 vs 127 ± 160 mL; p < 0.0001). Within the open distal pancreatectomy (ODP) group (n = 75), e‐BL was significantly less than i‐BL (168 ± 324 vs 281 ± 209 mL; p = 0.0017). The e‐BL > i‐BL trend in the LDP group was consistent, regardless of the indication for DP. In contrast, the finding of i‐BL > e‐BL in the ODP group was limited to patients with pancreatic cancer. Conclusion During LDP, e‐BL was significantly more than i‐BL. During ODP, e‐BL was significantly less than i‐BL, only in patients with pancreatic cancer. These results suggested the possibility of i‐BL underestimation during LDP, and overestimation during ODP in cases with pancreatic cancer.https://doi.org/10.1002/ags3.12888blood lossdistal pancreatectomyestimationlaparoscopicopen
spellingShingle Keisuke Toya
Yoshito Tomimaru
Shogo Kobayashi
Kazuki Sasaki
Yoshifumi Iwagami
Daisaku Yamada
Takehiro Noda
Hidenori Takahashi
Yuichiro Doki
Hidetoshi Eguchi
Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
Annals of Gastroenterological Surgery
blood loss
distal pancreatectomy
estimation
laparoscopic
open
title Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
title_full Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
title_fullStr Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
title_full_unstemmed Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
title_short Possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
title_sort possibility of incorrect evaluation of intraoperative blood loss during open and laparoscopic distal pancreatectomy
topic blood loss
distal pancreatectomy
estimation
laparoscopic
open
url https://doi.org/10.1002/ags3.12888
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