This is a single, retrospective, real-world study to investigate the surgical outcomes of minimally invasive pancreatoduodenectomy and open pancreatoduodenectomy, with the perioperative characteristics and long-term overall survival being compared. The investigators aimed to find out whether the minimally invasive surgery is safe and feasible for resectable lesions located in the pancreatic head and periampullary region. And the investigators also want to find out patients with what kind of characteristic can be benefit from the minimally invasive surgery compared with the open approach.
Pancreatoduodenectomy (Whipple surgery) is a complex surgical procedure and has been accepted as the gold standard treatment for resectable lesions of the pancreatic head and periampullary region.To date, how surgeons can safely pass the learning curve of laparoscopic pancreatoduodenectomy (LPD) without potentially harming patients remains a question. Around this topic, the investigators designed real-world study in a single center to retrospectively collect the PD surgeries since July 2014. The investigators aimed to find out whether the minimally invasive surgery is safe and feasible for resectable lesions located in the pancreatic head and periampullary region. And the investigators also want to find out patients with what kind of characteristic can be benefit from the minimally invasive surgery compared with the open approach. Besides, the investigators also want to investigate the clinical characteristics of patients and perioperative outcomes of LPD procedures and aimed to develop and validate a difficulty scoring system for patient selection which could help facilitate a comprehensive and security understanding of LPD for surgeon during different stage of the learning curve.
Study Type
OBSERVATIONAL
Enrollment
800
Pancreatoduodenectomy (Whipple surgery) is a complex surgical procedure and has been accepted as the gold standard treatment for resectable lesions of the pancreatic head and periampullary region
Postoperative length of stay
defined as the time from being admitted to hospital to discharge
Time frame: up to 90 days
Overall survival
defined as the duration from the first day after surgery to either the date of death or the last follow-up
Time frame: through study completion, an average of 5 year
Operation time
defined as the time from skin incision or trocar placement to complete skin closure
Time frame: intraoperative
postoperative complications
Postoperative complications were reviewed within 90 days after surgery and graded according to Clavien-Dindo (CD) classification system. Postoperative biliary leakage, hemorrhage, and liver failure. Wound infection was defined as purulent drainage from the incision or/and positive findings of culture of the fluid or tissue aseptically obtained from the incision.
Time frame: up to 90 days
Reoperation within 90 days
defined as any reoperation within 90 days
Time frame: up to 90 days
Mortality
defined as any death within 30 days and 90 days, respectively
Time frame: up to 90 days
Readmission within 90 days
defined as any readmission within 90 days
Time frame: up to 90 days
R0 resection
defined as tumor-free margins in all the reported surgical margins (biliary and circumferential margins
Time frame: intraoperative
Intraoperative blood loss
recorded by the anesthetist using a vacuum system
Time frame: intraoperative
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