Laparoscopic versus open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a propensity score matching analysis

Wiley - 2019
Wentao Zhou1,2, Weiwei Jin3,1, Dansong Wang2, Chao Lü3, Xuefeng Xu2, Ren-Chao Zhang3, Tiantao Kuang2, Yucheng Zhou3, Wen-Chuan Wu2, Dayong Jin2, Yiping Mou3, Wenhui Lou2
1Wentao Zhou and Weiwei Jin contributed equally to this work
2Department of General Surgery, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, 200032 P. R. China
3Department of Gastrointestinal and Pancreatic Surgery, Zhejiang Provincial People's Hospital, Key Laboratory of Gastroenterology of Zhejiang Province, People's Hospital of Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014 Zhejiang, P. R. China

Tóm tắt

AbstractBackgroundA growing body of evidence supports the use of laparoscopic pancreaticoduodenectomy (LPD) as an efficient and feasible surgical technique. However, few studies have investigated its applicability in pancreatic ductal adenocarcinoma (PDAC), and the long‐term efficacy of LPD on PDAC remains unclear. This study aimed to compare the short‐ and long‐term outcomes between LPD and open pancreaticoduodenectomy (OPD) for PDAC.MethodsThe data of patients who had OPD or LPD for PDAC between January 2013 and September 2017 were retrieved. Their postoperative outcomes and survival were compared after propensity score matching.ResultsA total of 309 patients were included. After a 2:1 matching, 93 cases in the OPD group and 55 in the LPD group were identified. Delayed gastric emptying (DGE), particularly grade B/C DGE, occurred less frequently in the LPD group than in the OPD group (1.8% vs. 36.6%, P < 0.001; 1.8% vs. 22.6%, P = 0.001). The overall complication rates were significantly lower in the LPD group than in the OPD group (49.1% vs. 71.0%, P = 0.008), whereas the rates of major complications were similar (10.9% vs. 14.0%, P = 0.590). In addition, the median overall survival was comparable between the two groups (20.0 vs. 18.7 months, P = 0.293).ConclusionLPD was found to be technically feasible with efficacy similar to OPD for patients with PDAC.

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