Long- and short-term survival following laparoscopic and open pancreaticoduodenectomy for patients with periampullary tumors in Vietnam

Tran Manh Hung; Tran Que Son; Tran Hieu Hoc; Tran Thanh Tung; Trieu Van Truong; Le Manh Cuong; Vu Duy Kien

doi:10.1016/j.amsu.2021.102690

Long- and short-term survival following laparoscopic and open pancreaticoduodenectomy for patients with periampullary tumors in Vietnam

Ann Med Surg (Lond). 2021 Aug 10:69:102690. doi: 10.1016/j.amsu.2021.102690. eCollection 2021 Sep.

Authors

Tran Manh Hung¹, Tran Que Son², Tran Hieu Hoc², Tran Thanh Tung¹, Trieu Van Truong¹, Le Manh Cuong³, Vu Duy Kien⁴

Affiliations

¹ Department of General Surgery, Bach Mai Hospital, No. 78 Giai Phong Street, Hanoi, Viet Nam.
² Hanoi Medical University, No. 1 Ton That Tung Street, Hanoi, Viet Nam.
³ National Hospital of Traditional Medicine, No. 29 Nguyen Binh Khiem Street, Hanoi, Viet Nam.
⁴ OnCare Medical Technology Company Limited, No. 77/508 Lang Street, Hanoi, Viet Nam.

Abstract

Background: Laparoscopic pancreaticoduodenectomy (LPD) is a less invasive alternative to the traditional open pancreaticoduodenectomy (OPD) approach used to treat periampullary tumors. However, previous studies examining the advantages of this surgery over OPD have produced mixed results. Here, a retrospective observational approach was used to compare the short- and long-term outcomes of patients with periampullary tumors who underwent LPD or OPD at a single institution in Vietnam.

Materials and methods: Data were obtained from hospital medical records collected over five years from patients that underwent OPD or LPD. Information on demographics, medical status, tumor characteristics, operative variables, complications, and mortality was examined. Survival curves were constructed and the stepwise multivariate Cox proportional hazard model was used to identify the factors associated with the risk of death following surgery.

Results: Eighty-four patients aged 26-80 years were included. Twenty-two patients underwent LPD and 62 received OPD. The operative time for the LPD group was significantly longer than that for the OPD group, and the LPD group was less likely to require a blood transfusion during surgery. While the short- and long-term survival rates did not differ for the procedures, the factors associated with the risk of death following surgery were tumors at the N1 stage and an age >65 years.

Conclusion: Both LPD and OPD procedures for treating periampullary tumors exhibited comparable safety profiles, with similar short-term outcomes and long-term survival rates observed. Future studies with a larger sample size should be conducted to further examine the treatment outcomes following these surgical approaches.

Keywords: Cancer; Laparoscopic pancreaticoduodenectomy; Open pancreaticoduodenectomy; Outcomes; Survival; Vietnam.