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:
Zdroj: Surgical Endoscopy. 36:2070-2080
ISSN: 1432-2218
0930-2794
DOI: 10.1007/s00464-021-08493-z
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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