Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy.
Adolescent
Adult
Aged
Blood Loss, Surgical
Blood Transfusion
Carcinoma, Pancreatic Ductal
/ surgery
Cohort Studies
Female
Humans
Laparoscopy
/ methods
Length of Stay
Male
Middle Aged
Operative Time
Pancreatic Fistula
/ epidemiology
Pancreatic Neoplasms
/ surgery
Pancreaticoduodenectomy
/ methods
Postoperative Complications
/ epidemiology
Retrospective Studies
Young Adult
Laparoscopic assisted pancreaticoduodenectomy
Open pancreaticoduodenectomy
Pancreatic fistula
Safety
Journal
BMC surgery
ISSN: 1471-2482
Titre abrégé: BMC Surg
Pays: England
ID NLM: 100968567
Informations de publication
Date de publication:
06 May 2020
06 May 2020
Historique:
received:
10
02
2020
accepted:
22
04
2020
entrez:
8
5
2020
pubmed:
8
5
2020
medline:
23
9
2020
Statut:
epublish
Résumé
The safety of total laparoscopic pancreaticoduodenectomy still remains controversial. Laparoscopic assisted pancreaticoduodenectomy (LAPD) may be an alternative selection. The purpose of the present study is to compare a consecutive cohort of LAPD and open pancreaticoduodenectomy (OPD) from a single surgeon. A comparison was conducted between LAPD and OPD from January 2013 to December 2018. Perioperative outcomes and short-term oncological results were compared. Univariate and multivariable analyses were performed to determine associations among variables. 133 patients were enrolled, 36 patients (27.1%) underwent LAPD and 97 (72.9%) underwent OPD. No 30-day and 90-day mortality occurred. LAPD was associated with decreased intraoperative estimated blood loss (300 versus 500 ml; P = 0.002), longer operative time (372 versus 305 min; P < 0.001) compared with OPD. LAPD had a conversion rate of 16.7%, and wasn't associated with an increased grade B/C pancreatic fistula rate, major surgical complications, intraoperative blood transfusion, reoperation rate or length of hospital stay after surgery. In the subset of 58 pancreatic ductal adenocarcinomas, R0 resection rate, median total harvested lymph node or lymph nodes ≥12 did not differ between the two groups. LAPD could be performed with non-inferior short-term perioperative and oncologic outcomes achieved by OPD in selected patients.
Sections du résumé
BACKGROUND
BACKGROUND
The safety of total laparoscopic pancreaticoduodenectomy still remains controversial. Laparoscopic assisted pancreaticoduodenectomy (LAPD) may be an alternative selection. The purpose of the present study is to compare a consecutive cohort of LAPD and open pancreaticoduodenectomy (OPD) from a single surgeon.
METHODS
METHODS
A comparison was conducted between LAPD and OPD from January 2013 to December 2018. Perioperative outcomes and short-term oncological results were compared. Univariate and multivariable analyses were performed to determine associations among variables.
RESULTS
RESULTS
133 patients were enrolled, 36 patients (27.1%) underwent LAPD and 97 (72.9%) underwent OPD. No 30-day and 90-day mortality occurred. LAPD was associated with decreased intraoperative estimated blood loss (300 versus 500 ml; P = 0.002), longer operative time (372 versus 305 min; P < 0.001) compared with OPD. LAPD had a conversion rate of 16.7%, and wasn't associated with an increased grade B/C pancreatic fistula rate, major surgical complications, intraoperative blood transfusion, reoperation rate or length of hospital stay after surgery. In the subset of 58 pancreatic ductal adenocarcinomas, R0 resection rate, median total harvested lymph node or lymph nodes ≥12 did not differ between the two groups.
CONCLUSION
CONCLUSIONS
LAPD could be performed with non-inferior short-term perioperative and oncologic outcomes achieved by OPD in selected patients.
Identifiants
pubmed: 32375728
doi: 10.1186/s12893-020-00752-5
pii: 10.1186/s12893-020-00752-5
pmc: PMC7201709
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
89Subventions
Organisme : China Academy of Medical Sciences Innovation Fund for Medical Sciences
ID : 2016-I2M-3-019
Organisme : National Natural Science Foundation of China
ID : 81972324
Organisme : non-profit Central Research Institute Fund of Chinese of Academy of Medical Sciences
ID : 2018PT32014
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