Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jan 30;21(1):26.
doi: 10.1186/s12957-023-02909-x.

Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study

Bin Zhang #  1 , Zipeng Xu #  2 , Weifang Gu #  3 , Junjing Zhou  4 , Neng Tang  5 , Shuo Zhang  5 , Chaobo Chen  6   7   8 , Zhongjun Zhang  9
Affiliations

Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study

Bin Zhang et al. World J Surg Oncol. .

Abstract

Background: Although laparoscopic pancreaticoduodenectomy (LPD) has been accepted worldwide for treating pancreatic ductal adenocarcinoma (PDA), it is a very technical and challenging procedure. Also, it is unclear whether LPD is superior to open pancreaticoduodenectomy (OPD). This study summarized the experience and efficacy of LPD for treating PDA in our medical center.

Methods: This retrospective cohort study included patients with PDA admitted at the Affiliated Hospital of Jiangnan University from October 2019 and January 2021. Patients received either LPD or OPD. Clinical outcomes (operation time, duration of anesthesia, intraoperative hemorrhage), postoperative complications, and short-term outcomes were compared. Cox proportional hazard model and Kaplan-Meier method were used to analyze overall survival (OS) and progression-free survival (PFS).

Results: Among the PDA patients, 101 patients underwent surgical treatment, 4 patients converted from LPD to OPD, and 7 of them received conservative treatment. Forty-six patients were cured of LPD, and 1 of them died shortly after the operation. Moreover, 44 patients received OPD, and there were 2 postoperative deaths. There were significant differences in the location of the operation time, duration of anesthesia, postoperative hemorrhage, abdominal infections, and postoperative pneumonia between the two groups (all p < 0.05). Multivariate analysis showed that LPD was an independent factor negatively correlated with the incidence of pneumonia (relative risk (RR) = 0.072, 95%CI: 0.016-0.326, p = 0.001) and abdominal infection (RR = 0.182, 95%CI: 0.047-0.709, p = 0.014). Also, there were no differences in OS (hazard ratio (HR) = 1.46, 95%CI: 0.60-3.53, p = 0.40) and PFS (HR = 1.46, 95%CI: 0.64-3.32, p = 0.37) at 12 months between the two groups.

Conclusions: LPD could be efficacy and feasible for managing selected PDA patients. Also, LPD has a better effect in reducing postoperative pneumonia and abdominal infection compared to OPD.

Keywords: China; Laparoscopy; Pancreatic adenocarcinoma; Pancreaticoduodenectomy; Retrospective study.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Study flow diagram
Fig. 2
Fig. 2
Kaplan-Meier curves for progression-free survival and overall survival in patients who received LPD or OPD. A Overall survival. B Progression-free survival
See this image and copyright information in PMC

References

    1. Kang CM, Lee WJ. Is Laparoscopic Pancreaticoduodenectomy Feasible for Pancreatic Ductal Adenocarcinoma? Cancers (Basel). 2020;12(11):3430. - PMC - PubMed
    1. Parmar A, Chaves-Porras J, Saluja R, Perry K, Rahmadian AP, Santos SD, et al. Adjuvant treatment for resected pancreatic adenocarcinoma: a systematic review and network meta-analysis. Crit Rev Oncol Hematol. 2020;145:102817. doi: 10.1016/j.critrevonc.2019.102817. - DOI - PubMed
    1. Yin Z, Jian Z, Hou B, Jin H. Surgical and oncological outcomes of laparoscopic versus open pancreaticoduodenectomy in patients with pancreatic duct adenocarcinoma. Pancreas. 2019;48(7):861–867. doi: 10.1097/MPA.0000000000001363. - DOI - PubMed
    1. Kim JH, Kim YI, Ahn JY, Shin WG, Yang HJ, Nam SY, et al. Long-term outcomes of endoscopic resection followed by additional surgery after non-curative resection in undifferentiated-type early gastric cancer: a nationwide multi-center study. Surg Endosc. 2022;36(3):1847–1856. doi: 10.1007/s00464-021-08464-4. - DOI - PubMed
    1. Strobel O, Neoptolemos J, Jager D, Buchler MW. Optimizing the outcomes of pancreatic cancer surgery. Nat Rev Clin Oncol. 2019;16(1):11–26. doi: 10.1038/s41571-018-0112-1. - DOI - PubMed