Minimally invasive pancreatoduodenectomy is increasingly performed. However, technical challenges and a perceived higher risk of complications has hindered wide adoption of a minimally invasive approach. This is a retrospective comparison of a prospectively kept database. The investigators compared surgical outcomes and survival after laparoscopic (LPD) versus open pancreatoduodenectomy (OPD). In order to reduce the effect of bias and confounding, baseline characteristics of both groups were matched using propensity score matching.
All pancreatoduodenectomies were retrieved from a prospectively kept database and retrospectively analysed. All procedures were performed in a single supra-regional Belgian centre. The primary endpoint was the major complication rate, defined by a Clavien-Dindo morbidity classification grade IIIa or higher \[11\]. Secondary endpoints were 90-day mortality rate, length of hospital stay, operative time, blood loss, transfusion requirements and specific pancreatic complications (pancreatic fistula, haemorrhage, and delayed gastric emptying). In addition, overall survival (OS) and disease-free survival (DFS) were analysed in the subgroups of cancer patients.
Study Type
OBSERVATIONAL
Enrollment
172
Patients included in the cohorts all underwent pancreatoduodenectomy, open or laparoscopic
General Hospital Groeninge
Kortrijk, Belgium
Major complication rate
Complications classified as morbidity classification 3a or greater (Clavien-Dindo)
Time frame: 90 days postoperative
Perioperative outcomes
Operative time (min), blood transfusion requirements, estimated blood loss (mL)
Time frame: Up to 30 days
Short-term postoperative outcomes
Hospital stay (days), drain in situ (days), ICU stay (days)
Time frame: Up to 30 days
Postoperative morbidity
All complications classified as morbidity classification 3a or greater (Clavien-Dindo)
Time frame: 90 days
Pancreatectomy-specific complications
Postoperative pancreatic fistula, Post-pancreatectomy haemorrhage, delayed gastric emptying, as defined by the respective ISGPS classification
Time frame: 90 days
Overall survival and disease-free survival
The Kaplan-Meier method was used for estimation of survival and compared between subgroups of cancer patients
Time frame: Up to 20 years
Oncological outcomes
Analysis of resection specimen following contemporary pathlogy guidelines and defined by TNM staging system of pancreatic cancer by AJCC/UICC.
Time frame: Up to 20 years
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