Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy
Abstract 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...
Main Authors: | , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
BMC
2020-05-01
|
Series: | BMC Surgery |
Subjects: | |
Online Access: | http://link.springer.com/article/10.1186/s12893-020-00752-5 |
id |
doaj-2c77de631ac04a42963d29bac018fa85 |
---|---|
record_format |
Article |
spelling |
doaj-2c77de631ac04a42963d29bac018fa852020-11-25T02:00:31ZengBMCBMC Surgery1471-24822020-05-012011910.1186/s12893-020-00752-5Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomyFeng Tian0Yi-zhi Wang1Su-rong Hua2Qiao-fei Liu3Jun-chao Guo4Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeDepartment of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeAbstract 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 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 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 LAPD could be performed with non-inferior short-term perioperative and oncologic outcomes achieved by OPD in selected patients.http://link.springer.com/article/10.1186/s12893-020-00752-5Open pancreaticoduodenectomyLaparoscopic assisted pancreaticoduodenectomyPancreatic fistulaSafety |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Feng Tian Yi-zhi Wang Su-rong Hua Qiao-fei Liu Jun-chao Guo |
spellingShingle |
Feng Tian Yi-zhi Wang Su-rong Hua Qiao-fei Liu Jun-chao Guo Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy BMC Surgery Open pancreaticoduodenectomy Laparoscopic assisted pancreaticoduodenectomy Pancreatic fistula Safety |
author_facet |
Feng Tian Yi-zhi Wang Su-rong Hua Qiao-fei Liu Jun-chao Guo |
author_sort |
Feng Tian |
title |
Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
title_short |
Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
title_full |
Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
title_fullStr |
Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
title_full_unstemmed |
Laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
title_sort |
laparoscopic assisted pancreaticoduodenectomy: an important link in the process of transition from open to total laparoscopic pancreaticoduodenectomy |
publisher |
BMC |
series |
BMC Surgery |
issn |
1471-2482 |
publishDate |
2020-05-01 |
description |
Abstract 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 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 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 LAPD could be performed with non-inferior short-term perioperative and oncologic outcomes achieved by OPD in selected patients. |
topic |
Open pancreaticoduodenectomy Laparoscopic assisted pancreaticoduodenectomy Pancreatic fistula Safety |
url |
http://link.springer.com/article/10.1186/s12893-020-00752-5 |
work_keys_str_mv |
AT fengtian laparoscopicassistedpancreaticoduodenectomyanimportantlinkintheprocessoftransitionfromopentototallaparoscopicpancreaticoduodenectomy AT yizhiwang laparoscopicassistedpancreaticoduodenectomyanimportantlinkintheprocessoftransitionfromopentototallaparoscopicpancreaticoduodenectomy AT suronghua laparoscopicassistedpancreaticoduodenectomyanimportantlinkintheprocessoftransitionfromopentototallaparoscopicpancreaticoduodenectomy AT qiaofeiliu laparoscopicassistedpancreaticoduodenectomyanimportantlinkintheprocessoftransitionfromopentototallaparoscopicpancreaticoduodenectomy AT junchaoguo laparoscopicassistedpancreaticoduodenectomyanimportantlinkintheprocessoftransitionfromopentototallaparoscopicpancreaticoduodenectomy |
_version_ |
1724959968236404736 |