The outcome of laparoscopic pancreatoduodenectomy is improved with patient selection and the learning curve
| Autor: | Jeanne Dembinski, Fadhel Samir Ftériche, Chihebeddine Romdhani, Alain Sauvanet, Béatrice Aussilhou, Safi Dokmak |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Adenocarcinoma 030230 surgery Lower risk Gastroenterology Pancreaticoduodenectomy 03 medical and health sciences Postoperative Complications 0302 clinical medicine Internal medicine medicine Humans In patient Retrospective Studies R0 resection business.industry Patient Selection Length of Stay Hepatology medicine.disease Pancreatic Neoplasms Pancreatic fistula Female Laparoscopy 030211 gastroenterology & hepatology Surgery business Very high risk Learning Curve Abdominal surgery |
| Zdroj: | Surgical Endoscopy. 36:2070-2080 |
| ISSN: | 1432-2218 0930-2794 |
| Popis: | In our first experience, laparoscopic pancreatoduodenectomy (LPD) was associated with higher morbidity than open PD. Since, the surgical technique has been improved and LPD was avoided in some patients at very high risk of postoperative pancreatic fistula (POPF). We provide our most recent results. Between 2011 and 2018, 130 LPD were performed and divided into 3 consecutive periods based on CUSUM analysis and compared: first period (n = 43), second period (n = 43), and third period (n = 44). In the third period of this study, LPD was more frequently performed in women (46%, 39%, 59%, p = 0.21) on dilated Wirsung duct > 3 mm (40%, 44%, 57%; p = 0.54). Intraductal papillary mucinous neoplasm (IPMN) became the primary indication (12%, 39%, 34%; p = 0.037) compared to pancreatic adenocarcinoma (35%, 16%, 16%; p = 0.004). Malignant ampulloma re-increased during the third period (30%, 9%, 20%; p = 0.052) with the amelioration of surgical technique. The operative time increased during the second period and decreased during the third period (330, 345, 270; p |
| Databáze: | OpenAIRE |
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