Short-term clinical outcomes of laparoscopic pancreaticoduodenectomy <i>versus</i> open pancreatoduodenectomy: a retrospective analysis_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

YANG Fan ^1,2 , ZHONG Guochao ¹ , YOU Ke ¹ ,  LIU Zuojin ¹

1. Department of Hepatobiliary Surgery, the Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, P. R. China;
2. Department of General Surgery, the People’s Hospital of Chishui, Chishui, Guizhou 564700, P. R. China;

Corresponding author：

LIU Zuojin, Email: liuzuojin66@hotmail.com

Keywords：

laparoscope; pancreatoduodenectomy; short-term curative effect

DOI：

10.7507/1007-9424.201901062

Video：

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Objective To compare the short-term clinical outcomes of laparoscopic pancreaticoduodenectomy (LPD) with open pancreatoduodenectomy (OPD).Methods Clinical data of 29 patients receiving LPD and 27 patients receiving OPD in the department of hepatobiliary surgery of the Second Affiliated Hospital of Chongqing Medical University from March 2016 to December 2018 were collected. Note that both LPD and OPD were performed by the same chief surgeon. Effectiveness and safety of LPD were compared with those of OPD.Results There was no significant difference in age, sex, body mass index, total bilirubin level, direct bilirubin level, preoperative morbidities, focus size, TNM stage and ASA grade between the LPD group and the OPD group (P>0.05). The operative time of the LPD group was significantly longer than that of the OPD group ［(482±86 ) min vs. (349±73) min, P<0.01］. Patients in the LPD group had shorter postoperative anal exhaust time than that in the OPD group ［(3.3±0.8) d vs. (5.3±1.0) d , P<0.05］. There was no significant difference in the length of hospital stay after operation, blood loss in operation, transfusion, second operation, death and postoperative complications between the LPD group and the OPD group (P>0.05).Conclusions The preliminary results of this study suggest that compared with OPD, LPD can shorten the postoperative anal exhaust time but not increase the incidence of postoperative complications and blood loss in operation. Nevertheless, this conclusion is needed to be validated by clinical studies with large sample size.

Citation： YANG Fan, ZHONG Guochao, YOU Ke, LIU Zuojin. Short-term clinical outcomes of laparoscopic pancreaticoduodenectomy versus open pancreatoduodenectomy: a retrospective analysis. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(6): 685-690. doi: 10.7507/1007-9424.201901062 Copy

1.	严辉弟, 周立新, 王茂林, 等. 腹腔镜腹股沟疝修补术后慢性疼痛的临床特征及危险因素分析. 中国普外基础与临床杂志, 2019, 26(2): 180-184.
2.	刘学青, 冯峰, 段佳悦, 等. 腹腔镜胰十二指肠切除术经验及术中技巧总结. 腹腔镜外科杂志, 2018, 23(5): 321-325.
3.	段小辉, 毛先海, 蒋波, 等. 腹腔镜胰十二指肠切除术治疗远端胆管癌的临床疗效. 中华消化外科杂志, 2018, 17(3): 304-309.
4.	刘文涵, 闫沛静, 胡东平, 等. 机器人与腹腔镜直肠癌全系膜切除术短期疗效对比分析. 中国普外基础与临床杂, 2019, 26(1): 31-37.
5.	李中辉, 陈华, 陈宏泽, 等. 腹腔镜保留脾脏胰体尾切除术17例报道. 中国普外基础与临床杂志, 2018, 25(8): 929-933.
6.	张亚武, 王哲元, 权柯. 腹腔镜与开腹胰十二指肠切除术治疗胰头癌的疗效对比分析. 中国普外基础与临床杂, 2015, 22(9): 1078-1082.
7.	林荣贵, 黄鹤光, 陈燕昌, 等. 腹腔镜胰十二指肠切除术胰腺颈部离断的方法选择. 中华外科杂志, 2017, 55(9): 667-670.
8.	张建生, 王文斌, 刘建华. 腹腔镜胰十二指肠切除术若干关键问题. 中国实用外科杂志, 2018, 38(7): 741-746.
9.	柴伟, 张执全, 李凤山, 等. 腹腔镜胰十二指肠切除术的近期疗效观察. 中华普通外科杂志, 2018, 33(9): 737-741.
10.	陈思瑞, 蔡云强, 彭兵. 腹腔镜胰十二指肠切除术后并发症处理经验. 中国普外基础与临床杂志, 2017, 24(7): 819-824.
11.	王建玲, 王强, 田志龙. 胰十二指肠切除术的单层胰胃吻合. 中国普外基础与临床杂志, 2001, 8(6): 416-417.
12.	蔡合, 蔡云强, 李永彬, 等. 腹腔镜胰十二指肠切除术在年龄≥70岁患者中的安全性研究. 中华消化外科杂志, 2017, 16(10): 1029-1035.
13.	金巍巍, 徐晓武, 牟一平, 等. 腹腔镜胰十二指肠切除术单中心233例临床经验总结. 中华外科杂志, 2017, 55(5): 354-358.
14.	刘建华, 王文斌, 刘学青, 等. 腹腔镜胰十二指肠切除术中的三点技术创新. 中华腔镜外科杂志(电子版), 2018, 11(1): 12-16.
15.	唐荣, 郑辉, 陈杰, 丁岩江. 腹腔镜胰十二指肠切除术对胰头癌术后并发症及预后的影响分析. 中国医学前沿杂志(电子版), 2017, 9(2): 84-87.
16.	吴耐, 张蓬波, 任泽强. 胰十二指肠切除术后胰瘘发生的危险因素及风险预测. 中国普外基础与临床杂志, 2018, 25(7): 889-894.
17.	张伟, 温馨, 曹宽, 等. 胰十二指肠切除术后胰瘘的影响因素及胰瘘风险评分系统对其术后主胰管引流方式选择的价值. 中国普外基础与临床杂志, 2019, 26(1): 42-48.
18.	Gagner M, Pomp A. Laparoscopic pylorus-preserving panc-reatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
19.	魏秋亚, 刘永永, 闫卫峰, 等. 全腹腔镜与开腹胰十二指肠切除术的临床配对研究. 中华肝胆外科杂志, 2016, 22(5): 332-335.
20.	卫洪波, 魏波, 郑宗珩, 等. 腹腔镜与开放胰十二指肠切除术疗效的对比观察. 中华胃肠外科杂志, 2014, 17(5): 465-468.
21.	Zhang H, Guo X, Xia J, et al. Comparison of totally 3-dimensional laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy. Pancreas, 2018, 47(5): 592-600.
22.	Song KB, Kim SC, Hwang DW, et al. Matched case-control analysis comparing laparoscopic and open pylorus-preserving pancreaticoduodenectomy in patients with periampullary tumors. Ann Surg, 2015, 262(1): 146-55.
23.	王文斌, 闫长青, 吕海涛, 等. 腹腔镜与开腹胰十二指肠切除术疗效分析. 中华肝胆外科杂志, 2017, 23(2): 110-113.
24.	胡金萌, 董久兴, 秦泰, 等. 胰十二指肠切除术118例单中心临床经验. 中华肝胆外科杂志, 2018, 24(8): 542-544.
25.	武春涛, 刘亮, 徐华祥, 等. 胰十二指肠切除术后出血的诊断与治疗-单中心临床经验. 中国普外基础与临床杂志, 2017, 24(6): 680-684.
26.	程智猛, 程南生, 熊先泽, 等. 胰十二指肠切除术后胃瘫的危险因素分析. 中国普外基础与临床杂志, 2016, 23(8): 1018-1023.
27.	黄明全, 陈阳, 王力, 等. 胰肠吻合方式与胰十二指肠切除术后并发症相关性的meta分析. 中国普外基础与临床杂志, 2016, 23(10): 1253-1258.
28.	黄永刚, 顾卯林, 朱景元, 等. 胰十二指肠切除术后胰肠吻合口假性囊肿自发性破裂1例报道. 中国普外基础与临床杂志, 2016, 23(12): 1544-1544.
29.	吕飞飞, 赵海平, 胡文秀, 等. 胰十二指肠切除术围手术期并发症临床分析. 中国普外基础与临床杂志, 2013, 20(7): 728-731.
30.	张乙川, 蔡云强, 高攀, 等. 保留幽门的腹腔镜胰十二指肠切除术安全性及可行性分析. 局解手术学杂志, 2017, 26(5): 348-351.
31.	陈佰文, 裘铠杰, 李宏. 腹腔镜胰十二指肠切除术的可行性和安全性. 肝胆胰外科杂志, 2017, 29(5): 411-414.
32.	Kantor O, Talamonti MS, Sharpe S, et al. Laparoscopic pancreaticoduodenectomy for adenocarcinoma provides short-term oncologic outcomes and long-term overall survival rates similar to those for open pancreaticoduodenectomy. Am J Surg, 2017, 213(3): 512-515.

1. 严辉弟, 周立新, 王茂林, 等. 腹腔镜腹股沟疝修补术后慢性疼痛的临床特征及危险因素分析. 中国普外基础与临床杂志, 2019, 26(2): 180-184.
2. 刘学青, 冯峰, 段佳悦, 等. 腹腔镜胰十二指肠切除术经验及术中技巧总结. 腹腔镜外科杂志, 2018, 23(5): 321-325.
3. 段小辉, 毛先海, 蒋波, 等. 腹腔镜胰十二指肠切除术治疗远端胆管癌的临床疗效. 中华消化外科杂志, 2018, 17(3): 304-309.
4. 刘文涵, 闫沛静, 胡东平, 等. 机器人与腹腔镜直肠癌全系膜切除术短期疗效对比分析. 中国普外基础与临床杂, 2019, 26(1): 31-37.
5. 李中辉, 陈华, 陈宏泽, 等. 腹腔镜保留脾脏胰体尾切除术17例报道. 中国普外基础与临床杂志, 2018, 25(8): 929-933.
6. 张亚武, 王哲元, 权柯. 腹腔镜与开腹胰十二指肠切除术治疗胰头癌的疗效对比分析. 中国普外基础与临床杂, 2015, 22(9): 1078-1082.
7. 林荣贵, 黄鹤光, 陈燕昌, 等. 腹腔镜胰十二指肠切除术胰腺颈部离断的方法选择. 中华外科杂志, 2017, 55(9): 667-670.
8. 张建生, 王文斌, 刘建华. 腹腔镜胰十二指肠切除术若干关键问题. 中国实用外科杂志, 2018, 38(7): 741-746.
9. 柴伟, 张执全, 李凤山, 等. 腹腔镜胰十二指肠切除术的近期疗效观察. 中华普通外科杂志, 2018, 33(9): 737-741.
10. 陈思瑞, 蔡云强, 彭兵. 腹腔镜胰十二指肠切除术后并发症处理经验. 中国普外基础与临床杂志, 2017, 24(7): 819-824.
11. 王建玲, 王强, 田志龙. 胰十二指肠切除术的单层胰胃吻合. 中国普外基础与临床杂志, 2001, 8(6): 416-417.
12. 蔡合, 蔡云强, 李永彬, 等. 腹腔镜胰十二指肠切除术在年龄≥70岁患者中的安全性研究. 中华消化外科杂志, 2017, 16(10): 1029-1035.
13. 金巍巍, 徐晓武, 牟一平, 等. 腹腔镜胰十二指肠切除术单中心233例临床经验总结. 中华外科杂志, 2017, 55(5): 354-358.
14. 刘建华, 王文斌, 刘学青, 等. 腹腔镜胰十二指肠切除术中的三点技术创新. 中华腔镜外科杂志(电子版), 2018, 11(1): 12-16.
15. 唐荣, 郑辉, 陈杰, 丁岩江. 腹腔镜胰十二指肠切除术对胰头癌术后并发症及预后的影响分析. 中国医学前沿杂志(电子版), 2017, 9(2): 84-87.
16. 吴耐, 张蓬波, 任泽强. 胰十二指肠切除术后胰瘘发生的危险因素及风险预测. 中国普外基础与临床杂志, 2018, 25(7): 889-894.
17. 张伟, 温馨, 曹宽, 等. 胰十二指肠切除术后胰瘘的影响因素及胰瘘风险评分系统对其术后主胰管引流方式选择的价值. 中国普外基础与临床杂志, 2019, 26(1): 42-48.
18. Gagner M, Pomp A. Laparoscopic pylorus-preserving panc-reatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
19. 魏秋亚, 刘永永, 闫卫峰, 等. 全腹腔镜与开腹胰十二指肠切除术的临床配对研究. 中华肝胆外科杂志, 2016, 22(5): 332-335.
20. 卫洪波, 魏波, 郑宗珩, 等. 腹腔镜与开放胰十二指肠切除术疗效的对比观察. 中华胃肠外科杂志, 2014, 17(5): 465-468.
21. Zhang H, Guo X, Xia J, et al. Comparison of totally 3-dimensional laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy. Pancreas, 2018, 47(5): 592-600.
22. Song KB, Kim SC, Hwang DW, et al. Matched case-control analysis comparing laparoscopic and open pylorus-preserving pancreaticoduodenectomy in patients with periampullary tumors. Ann Surg, 2015, 262(1): 146-55.
23. 王文斌, 闫长青, 吕海涛, 等. 腹腔镜与开腹胰十二指肠切除术疗效分析. 中华肝胆外科杂志, 2017, 23(2): 110-113.
24. 胡金萌, 董久兴, 秦泰, 等. 胰十二指肠切除术118例单中心临床经验. 中华肝胆外科杂志, 2018, 24(8): 542-544.
25. 武春涛, 刘亮, 徐华祥, 等. 胰十二指肠切除术后出血的诊断与治疗-单中心临床经验. 中国普外基础与临床杂志, 2017, 24(6): 680-684.
26. 程智猛, 程南生, 熊先泽, 等. 胰十二指肠切除术后胃瘫的危险因素分析. 中国普外基础与临床杂志, 2016, 23(8): 1018-1023.
27. 黄明全, 陈阳, 王力, 等. 胰肠吻合方式与胰十二指肠切除术后并发症相关性的meta分析. 中国普外基础与临床杂志, 2016, 23(10): 1253-1258.
28. 黄永刚, 顾卯林, 朱景元, 等. 胰十二指肠切除术后胰肠吻合口假性囊肿自发性破裂1例报道. 中国普外基础与临床杂志, 2016, 23(12): 1544-1544.
29. 吕飞飞, 赵海平, 胡文秀, 等. 胰十二指肠切除术围手术期并发症临床分析. 中国普外基础与临床杂志, 2013, 20(7): 728-731.
30. 张乙川, 蔡云强, 高攀, 等. 保留幽门的腹腔镜胰十二指肠切除术安全性及可行性分析. 局解手术学杂志, 2017, 26(5): 348-351.
31. 陈佰文, 裘铠杰, 李宏. 腹腔镜胰十二指肠切除术的可行性和安全性. 肝胆胰外科杂志, 2017, 29(5): 411-414.
32. Kantor O, Talamonti MS, Sharpe S, et al. Laparoscopic pancreaticoduodenectomy for adenocarcinoma provides short-term oncologic outcomes and long-term overall survival rates similar to those for open pancreaticoduodenectomy. Am J Surg, 2017, 213(3): 512-515.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Short-term clinical outcomes of laparoscopic pancreaticoduodenectomy versus open pancreatoduodenectomy: a retrospective analysis

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