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Meta-Analysis
. 2019 Aug 7;19(1):781.
doi: 10.1186/s12885-019-6001-x.

Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis

Yu-Li Jiang  1 , Ren-Chao Zhang  2 , Yu-Cheng Zhou  2
Affiliations
Meta-Analysis

Comparison of overall survival and perioperative outcomes of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis

Yu-Li Jiang et al. BMC Cancer. .

Abstract

Background: The aim of this study was to compare the oncological outcomes and clinical efficacy of laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods: We systematically searched PubMed, EMBASE, Web of Science, ClinicalTrials.gov and the Cochrane Central Register for studies published between May 1998 and May 2018. The included studies compared LPD and OPD for the treatment of PDAC. The oncological outcomes and perioperative data were analyzed.

Results: Eight studies involving 15,278 patients were included in our meta-analysis. No significant difference was found in the 5-year overall survival (OS) between patients undergoing the two types of surgery (HR: 0.97, 95% CI 0.82-1.15, p = 0.76). LPD resulted in a higher rate of R0 resection than OPD (OR: 1.16, 95% CI 0.85-1.57, p > 0.05). This study showed that compared with OPD, LPD resulted in comparable rates of postoperative pancreatic fistulas (POPFs) (OR: 1.07, 95% CI: 0.68-1.68, p = 0.77) and postoperative hemorrhage (OR: 1.74, 95% CI 0.96-3.71, p = 0.07), more harvested lymph nodes (WMD: 1.84, 95% CI: 0.95-2.72, p < 0.05), shorter hospital stays (WMD: -2.45, 95% CI: - 3.33- -1.56, p < 0.05), and less estimated blood loss (WMD: -374.30, 95% CI: - 513.06- -235.54, p < 0.05).

Conclusions: LPD is equivalent to OPD with respect to 5-year OS and results in better perioperative clinical outcomes for patients with PDAC.

Keywords: Laparoscopic pancreaticoduodenectomy; Oncological outcome; Open pancreaticoduodenectomy; PDAC.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flow diagram of the process for the selection of relevant studies
Fig. 2
Fig. 2
Forest plot for 5-year OS between the LPD and OPD for PDCA
Fig. 3
Fig. 3
Forest plot for R0 resection between the LPD and OPD for PDCA
Fig. 4
Fig. 4
Forest plot for Lymph node harvested between the LPD and OPD for PDCA
Fig. 5
Fig. 5
Forest plot for POPF between the LPD and OPD for PDCA
Fig. 6
Fig. 6
Forest plot for Estimated blood loss between the LPD and OPD for PDCA
Fig. 7
Fig. 7
Forest plot for Postoperative bleeding between the LPD and OPD for PDCA
Fig. 8
Fig. 8
Forest plot for Hospital stay between the LPD and OPD for PDCA
See this image and copyright information in PMC

Comment in

References

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