Laparoscopic Pancreaticodudenectomy for Periampullary Tumor: Should it be a Routine? A Propensity Score-matched Study
| Autor: | Ayman El Nakeeb, Aly Salem, Ahmed A El-Geidi, Helmy Ezzat, Talaat Abd Allah, Emad El Hefnawy, Ahmed Shehta, Hosam Hamed, Mohamed El Sorogy, Omar Fathy, Mohamed Abd El Gawad, Amgad Zaghloul, Mohamed F. Attia |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Operative Time 030230 surgery Pancreaticoduodenectomy 03 medical and health sciences 0302 clinical medicine Postoperative Complications hemic and lymphatic diseases Medicine Humans Propensity Score Lymph node Survival rate Retrospective Studies business.industry Length of Stay Middle Aged Surgery Pancreatic Neoplasms Survival Rate Dissection medicine.anatomical_structure Treatment Outcome Propensity score matching Matched group Operative time 030211 gastroenterology & hepatology Periampullary tumor Female Laparoscopy business |
| Zdroj: | Surgical laparoscopy, endoscopypercutaneous techniques. 30(1) |
| ISSN: | 1534-4908 |
| Popis: | Introduction Laparoscopic pancreaticoduodenectomy (LPD) is a complex and challenging procedure even with experienced surgeons. The aim of this study is to evaluate the feasibility and surgical and oncological outcomes of LPD compared with open pancreaticoduodenectomy (OPD). Patients and method This is a propensity score-matched analysis for patients with periampullary tumors who underwent PD. Patients underwent LPD and matched group underwent OPD included in the study. The primary outcome measure was the rate of total postoperative morbidities. Secondary outcomes included operative times, hospital stay, wound length and cosmosis, oncological outcomes, recurrence rate, and survival rate. Results A total of 111 patients were included in the study (37 LPD and 74 OPD). The conversion rate from LPD to OPD was 4 cases (10.8%). LPD provides significantly shorter hospital stay (7 vs. 10 d; P=0.004), less blood loss (250 vs. 450 mL, P=0.001), less postoperative pain, early oral intake, and better cosmosis. The length of the wound is significantly shorter in LPD. The operative time needed for dissection and reconstruction was significantly longer in LPD group (420 vs. 300 min; P=0.0001). Both groups were comparable as regards lymph node retrieved (15 vs. 14; P=0.21) and R0 rate (86.5% vs. 83.8%; P=0.6). No significant difference was seen as regards postoperative morbidities, re-exploration, readmission, recurrence, and survival rate. Conclusions LPD is a feasible procedure; it provided a shorter hospital stay, less blood loss, earlier oral intake, and better cosmosis than OPD. It had the same postoperative complications and oncological outcomes as OPD. |
| Databáze: | OpenAIRE |
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