Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis
Abstract Background The aim of this study was to compare the oncological outcomes and clinical efficacy of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in patients with pancreatic ductal adenocarcinoma (PDAC). Methods We systematically searched PubMed, EMBASE, We...
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doaj-ff60733832c04985aa16487e49ecff952020-11-25T02:49:00ZengBMCBMC Cancer1471-24072019-08-011911910.1186/s12885-019-6001-xComparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysisYu-Li Jiang0Ren-Chao Zhang1Yu-Cheng Zhou2School of Medicine, Hang Zhou Normal UniversityDepartment of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Key Laboratory of Gastroenterology of Zhejiang Province, People’s Hospital of Hangzhou Medical CollegeDepartment of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People’s Hospital, Key Laboratory of Gastroenterology of Zhejiang Province, People’s Hospital of Hangzhou Medical CollegeAbstract Background The aim of this study was to compare the oncological outcomes and clinical efficacy of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in patients with pancreatic ductal adenocarcinoma (PDAC). Methods We systematically searched PubMed, EMBASE, Web of Science, ClinicalTrials.gov and the Cochrane Central Register for studies published between May 1998 and May 2018. The included studies compared LPD and OPD for the treatment of PDAC. The oncological outcomes and perioperative data were analyzed. Results Eight studies involving 15,278 patients were included in our meta-analysis. No significant difference was found in the 5-year overall survival (OS) between patients undergoing the two types of surgery (HR: 0.97, 95% CI 0.82–1.15, p = 0.76). LPD resulted in a higher rate of R0 resection than OPD (OR: 1.16, 95% CI 0.85–1.57, p > 0.05). This study showed that compared with OPD, LPD resulted in comparable rates of postoperative pancreatic fistulas (POPFs) (OR: 1.07, 95% CI: 0.68–1.68, p = 0.77) and postoperative hemorrhage (OR: 1.74, 95% CI 0.96–3.71, p = 0.07), more harvested lymph nodes (WMD: 1.84, 95% CI: 0.95–2.72, p < 0.05), shorter hospital stays (WMD: -2.45, 95% CI: − 3.33- -1.56, p < 0.05), and less estimated blood loss (WMD: -374.30, 95% CI: − 513.06- -235.54, p < 0.05). Conclusions LPD is equivalent to OPD with respect to 5-year OS and results in better perioperative clinical outcomes for patients with PDAC.http://link.springer.com/article/10.1186/s12885-019-6001-xPDACLaparoscopic pancreaticoduodenectomyOpen pancreaticoduodenectomyOncological outcome |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Yu-Li Jiang Ren-Chao Zhang Yu-Cheng Zhou |
spellingShingle |
Yu-Li Jiang Ren-Chao Zhang Yu-Cheng Zhou Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis BMC Cancer PDAC Laparoscopic pancreaticoduodenectomy Open pancreaticoduodenectomy Oncological outcome |
author_facet |
Yu-Li Jiang Ren-Chao Zhang Yu-Cheng Zhou |
author_sort |
Yu-Li Jiang |
title |
Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
title_short |
Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
title_full |
Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
title_fullStr |
Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
title_full_unstemmed |
Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
title_sort |
comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis |
publisher |
BMC |
series |
BMC Cancer |
issn |
1471-2407 |
publishDate |
2019-08-01 |
description |
Abstract Background The aim of this study was to compare the oncological outcomes and clinical efficacy of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in patients with pancreatic ductal adenocarcinoma (PDAC). Methods We systematically searched PubMed, EMBASE, Web of Science, ClinicalTrials.gov and the Cochrane Central Register for studies published between May 1998 and May 2018. The included studies compared LPD and OPD for the treatment of PDAC. The oncological outcomes and perioperative data were analyzed. Results Eight studies involving 15,278 patients were included in our meta-analysis. No significant difference was found in the 5-year overall survival (OS) between patients undergoing the two types of surgery (HR: 0.97, 95% CI 0.82–1.15, p = 0.76). LPD resulted in a higher rate of R0 resection than OPD (OR: 1.16, 95% CI 0.85–1.57, p > 0.05). This study showed that compared with OPD, LPD resulted in comparable rates of postoperative pancreatic fistulas (POPFs) (OR: 1.07, 95% CI: 0.68–1.68, p = 0.77) and postoperative hemorrhage (OR: 1.74, 95% CI 0.96–3.71, p = 0.07), more harvested lymph nodes (WMD: 1.84, 95% CI: 0.95–2.72, p < 0.05), shorter hospital stays (WMD: -2.45, 95% CI: − 3.33- -1.56, p < 0.05), and less estimated blood loss (WMD: -374.30, 95% CI: − 513.06- -235.54, p < 0.05). Conclusions LPD is equivalent to OPD with respect to 5-year OS and results in better perioperative clinical outcomes for patients with PDAC. |
topic |
PDAC Laparoscopic pancreaticoduodenectomy Open pancreaticoduodenectomy Oncological outcome |
url |
http://link.springer.com/article/10.1186/s12885-019-6001-x |
work_keys_str_mv |
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