Introduction : Radical antegrade modular pancreatosplenectomy (RAMPS) was introduced to improve the tumor-free retroperitoneal margin and achieve adequate lymph node dissection in patients with left-sided pancreatic cancer. Despite recently increasing reports on laparoscopic distal pancreatectomy for pancreatic cancer, there have been few reports with a focus on laparoscopic RAMPS. The aim of this study is to evaluate the safety and oncologic efficacy of laparoscopic RAMPS for left-sided pancreatic cancer by comparing the surgical outcomes of laparoscopic and open surgery.

Methods : Between March 2003 and December 2016, 48 patients with left-sided pancreatic cancer underwent open and laparoscopic RAMPS. To overcome selection bias, 38 patients were selected after excluding the patients who required combined resection of other organs. Clinicopathologic and oncologic variables were compared between laparoscopic group (n=19) and open group (n=19).

Results : There were no statistical difference in demographic and pathologic data between two groups. Compared with open group, laparoscopic group had a short hospital stay (10.1 ?4.1 vs. 13.4 ?6.3 days, p=0.053) and was more likely to receive adjuvant chemotherapy (89.5% vs. 63.3%, p=0.056). The two groups did not differ significantly in terms of operative time, intraoperative blood loss, number of retrieved lymph nodes, resection margin status, and postoperative complications. The recurrence rate and overall survival rates were similar between two groups.

Conclusions : This study showed that laparoscopic RAMPS for left-sided pancreatic cancer was associated with shorter postoperative hospital stay and increased use of adjuvant chemotherapy compared to open surgery without compromising the perioperative and oncologic outcomes.