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The comparation of short-term outcome between laparoscopic and open pancreaticoduodenectomy: a propensity score matching analysis.
Ding, Wei; Wu, Wenze; Tan, Yulin; Chen, Xuemin; Duan, Yunfei; Sun, Donglin; Lu, Yunjie; Xu, Xuezhong.
Afiliación
  • Ding W; Department of Hepatopancreatobiliary Surgery, The Third Affiliated Hospital of Soochow University, #185 Juqian Road, Changzhou, 213003, China.
  • Wu W; Department of General Surgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, China.
  • Tan Y; Department of General Surgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, China.
  • Chen X; Department of Hepatopancreatobiliary Surgery, The Third Affiliated Hospital of Soochow University, #185 Juqian Road, Changzhou, 213003, China.
  • Duan Y; Department of General Surgery, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, 213003, Jiangsu, China.
  • Sun D; Department of General Surgery, Wujin Hospital Affiliated With Jiangsu University, Changzhou, 213017, China.
  • Lu Y; Department of General Surgery, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, China.
  • Xu X; Department of Hepatopancreatobiliary Surgery, The Third Affiliated Hospital of Soochow University, #185 Juqian Road, Changzhou, 213003, China.
Updates Surg ; 73(2): 419-427, 2021 Apr.
Article en En | MEDLINE | ID: mdl-33590350
Pancreaticoduodenectomy (PD) is one of the most complex and delicate operations in abdominal surgery. With the development of laparoscopic techniques, more and more pancreatic experts have become skilled in laparoscopic pancreaticoduodenectomy (LPD). However, the short-term efficacy of LPD compared to open pancreaticoduodenectomy (OPD) remains unclear. Here, we performed a propensity score matching study aiming to compare the short outcomes of patients who underwent LPD or OPD after the learning curve and established a risk model of pancreatic fistula. The data of 346 patients who had OPD or LPD from July 2015 to January 2020 were retrieved. After a 1:1 matching, 224 patients remained. The operation time was significantly longer (P = 0.001) but the amount of bleeding was significantly lower (P = 0.001) in the LPD group than in the OPD group. Patients in LPD group had fewer blood transfusions (P = 0.002) than those in OPD group. More lymph nodes (P < 0.001) were dissected in LPD group. The rate of grade B/C pancreatic fistula was significantly higher in the LPD group than in the OPD group (16.1% vs. 6.3%, P = 0.002). By multi variate Logistic regression analysis, we identified pancreatic tumor, malignancy and low body mass index were risk factors of Grade B/C pancreatic fistula after PD operation. Then, we developed a Grade B/C pancreatic fistula nomogram with the risk factors. The C-index of the nomogram was 0.836 (95% CI 0.762-0.910). In conclusion, LPD could be technically feasible, get less trauma and achieve similar short-term outcome as compared with OPD.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Laparoscopía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Updates Surg Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Italia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Pancreáticas / Laparoscopía Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Humans Idioma: En Revista: Updates Surg Año: 2021 Tipo del documento: Article País de afiliación: China Pais de publicación: Italia