Preliminary results of laparoscopic versus open pancreaticoduodenectomy in Vietnam: A retrospective analysis from a multi-center research

Asian J Surg. 2023 Feb;46(2):780-787. doi: 10.1016/j.asjsur.2022.07.030. Epub 2022 Jul 31.

Abstract

Introduction: The goal of this study was to compare the results of LPD with those of open pancreaticoduodenectomy (OPD).

Method: Data were retrospectively collected from a database of patients who underwent PD from January 2010 to May 2020. Intraoperative, postoperative, and follow-up assessment studies were conducted.

Results: A total of 149 patients were selected. Compared with OPD, LPD was fewer intraoperative blood transfusions (p = 0.015), a longer median operative time (p < 0.001), hospital stay (p = 0.034), a higher rate of bile leakage (p = 0.02), overall morbidity (p = 0.045), and re-operation (p = 0.044). There was no difference between the two groups in severe pancreatic fistula, postoperative bleeding, delayed gastric emptying, Clavien-Dindo classification ≥ III, or 30-day mortality. LPD had a similar number of excised lymph nodes, R0 resection rate, and long-term survival cases involving malignant tumors, ampulla of Vater cancer, and pancreatic ductal adenocarcinoma.

Conclusion: In the early period, the benefit of LPD has not been found as there was a high rate of conversion to laparotomy, morbidity, and re-operation. Despite that, LPD is a feasible oncological approach with long-term survival comparable to OPD.

Keywords: Laparoscopic; Open surgery; Overall survival; Pancreatic neoplasms; Pancreaticoduodenectomy.

Publication types

  • Multicenter Study

MeSH terms

  • Humans
  • Laparoscopy* / methods
  • Length of Stay
  • Pancreatic Neoplasms* / surgery
  • Pancreaticoduodenectomy / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / surgery
  • Retrospective Studies
  • Vietnam