Eleven studies were included in the review (1,091 participants): 10 studies were retrospective (979 patients) and one was prospective (112 patients). Four studies reportedly had matched pair designs. Two studies performed intention-to-treat analyses.
Overall conversion rate from laparoscopic to open surgery was 9.5% (common reasons for conversion were reported). Compared with open surgery, laparoscopic surgery had significantly less operative blood loss (237mL versus 562mL, p<0.001), a higher spleen preservation rate (37.8% versus 8%, p<0.001), lower morbidity (30.5% versus 38.4%, p=0.007), and shorter postoperative hospital stay (9.1 days versus 14.7 days, p<0.001).
Six of the nine studies that investigated the size of resected tumours reported smaller tumours with laparoscopy than with open surgery; only two studies reported this difference as being statistically significant. Most resected tumours were cystic neoplasms or neuroendocrine tumours; no notable differences observed between the two surgical approaches.
No significant differences were found between the two surgery types for operative time, rate of postoperative pancreatic fistula and mortality. Other results (use of postoperative analgesia, return of bowel function and return to normal activity) were reported in the paper.