Propensity score‐matched analysis of early outcomes after laparoscopic‐assisted versus open pancreaticoduodenectomy. Issue 5 (9th April 2019)

• Record Type: Journal Article
• Authors: Tan, Jarrod K. H.; Ng, Jun Jie; Yeo, Melissa; Koh, Frederick H. X.; Bonney, Glenn K.; Ganpathi, Iyer S.; Madhavan, Krishnakumar; Kow, Alfred W. C.
• Is Part Of: ANZ journal of surgery. Volume 89:Issue 5(2019)
• Page Start: E190
• Page End: E194
• Publication Date: 2019-04-09
• Subjects: head of pancreas tumour -- laparoscopic‐assisted pancreaticoduodenectomy -- laparoscopic surgery -- minimally invasive pancreaticoduodenectomy -- open pancreaticoduodenectomy -- pancreas surgery -- pancreaticoduodenectomy -- peri‐ampullary tumour -- Whipples procedure; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.15124
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract : Background: Minimally invasive pancreaticoduodenectomy (PD) is a feasible option for periampullary tumours. However, it remains a complex procedure with no proven advantages over open PD (OPD). The aim of the study was to compare the outcomes between laparoscopic‐assisted PD (LAPD) and OPD using a propensity score‐matched analysis. Methods: Retrospective review of 40 patients who underwent PD for periampullary tumours between January 2014 and December 2016 was conducted. The patients were matched 1:1 for age, gender, body mass index, Charlson comorbidty index, tumour size and haematological indices. Peri‐operative outcomes were evaluated. Results: LAPD appeared to have a longer median operative time as compared to OPD (LAPD, 425 min (285–597) versus OPD, 369 min (260–500)) ( P = 0.066). Intra‐operative blood loss was comparable between both groups. Respiratory complications were five times higher in the OPD group (LAPD, 5% versus OPD, 25%) ( P = 0.077), while LAPD patients required less time to start ambulating post‐operatively (LAPD, 2 days versus OPD, 2 days) ( P = 0.021). Pancreas‐specific complications and morbidity/mortality rates were similar. Conclusion: LAPD is a safe alternative to OPD in a select group of patients for an institution starting out with minimally invasive PD, and can be used to bridge the learning curve required for total laparoscopic PD.