Compare open and laparoscopic assisted pancreaticoduodenectomy regarding intraoprative blood loss, organ injury, completion of planned laparoscopic steps, duration and early post operative course of pain, hem stability, oral feeding, leakage(pancreatic, billary and intestinal). ,bleeding, mortality, lymph nodes and safety margins .
Pancreaticoduodenectomy is the only option curative intended in the treatment of resectable pancreatic ductal adenocarcinomas, duodenal carcinoma, ampullary carcinoma, lower common bile duct cholangiocarcinoma,. It is still associated with very high morbidity and mortality. \[1\]. Pancreatic cancer ranks as the seventh leading cause of cancer-related death worldwide, and the fourth among other cancers\[2,3\]. In recent years, the minimally invasive techniques has considered revolution in surgeries of pancreatic cancers \[4,5\]. Laparoscopic assisted pancreaticoduodenectomy is a hybrid procedure combining laparoscopic resection and reconstruction through a small incision.it companies laparoscopic mobilization and dissection due to magnification compared with open pancreaticoduodenectomy\[6\]. Several studies have shown that laparoscopic assisted pancreaticoduodenectomy could result in less blood loss less, pain ,less wound infection and shorter hospital stay compared to open pancreaticoduodenectomy\[7,8\]. Limited literature described the safety and efficacy of laparoscopic assisted pancraticododenostomy .Also such comparative studies deficient in evaluation of outcomes of laparoscopic assisted pancraticododenostomy and open pancraticoduodenoctomy.So the interest of our study is to compare between the feasibility and safety of laparoscopic assisted pancraticododenostomy and open pancraticoduodenoctomy.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
40
laparoscopic assisted pancreaticoduodenectomy.
Open pancreaticduodenctomy
post operative pain.
Compare the post operative pain betweenopen and laparoscopic assisted pancreaticoduodenectomy
Time frame: Compare the post operative pain between open and laparoscopic assisted pancreaticoduodenctomy in the first week after operation
Blood loss
Compare between the intra operative blood loss in the open and laparoscopic assisted pancreaticoduodenectomy
Time frame: Compare the intra operative blood loss between open and laparoscopic assisted pancreaticoduodenectomy during the operation
Rate of postoperative anastomosis leakage(pancreatic,billary and intestinal).
Compare the rate of postoperative anastomosis leakage(pancreatic,billary and intestinal) between the open and laparoscopic assisted pancreaticoduodenctomy
Time frame: Rate of postoperative anastomosis leakage(pancreatic,billary and intestinal) in the first month after operation
Postoperative haemorrhage
Compare between the postoperative haemorrhage by cc in the open and laparoscopic assisted pancreaticoduodenectomy
Time frame: In the first 2 weeks
Postoperative wound infection.
Compare between the postoperative wound infection in the open and laparoscopic assisted pancreaticoduodenectomy
Time frame: In the first 2 weeks
Starting oral feeding
Compare between starting oral feeding in the open and laparoscopic assisted pancreaticoduodenectomy
Time frame: In the first 3 days after operation
Postoperative 30 days mortality rate.
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Compare between the Postoperative 30 days mortality rate in the open and laparoscopic assisted pancreaticoduodenectomy
Time frame: In the first 30days after operation