Comparative study of perioperative efficacy between laparoscopic and open pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Kangyi , GAO Fengwei ,  LEI Zehua , WU Jianping , FU Jinqiang , DU Bo , WANG Zhixu , XIE Qingyun , ZHOU Quanyu , GONG Jie , XUE Qian , ZHAO Xin

Department of Hepatobiliary Pancreatic and Splenic Surgery, People’s Hospital of Leshan/HBPS Diseases Center for Diagnosis and Treatment of Leshan City, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

LEI Zehua, Email: leitsehua@126.com

Keywords：

pancreaticoduodenectomy; laparoscope; safety; efficacy

DOI：

10.7507/1007-9424.202008040

Video：

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Objective To investigate safety and effectiveness of laparoscopic pancreaticoduodenectomy (LPD) in municipal hospitals.Methods The clinic data of patients underwent pancreatoduodenectomy in the Leshan People’s Hospital from November 2017 to January 2020 were retrospectively analyzed. The patients were divided into LPD group and open pancreaticoduodenectomy (OPD) group according to the operation methods, and the indicators of perioperative safety and effectiveness of the two groups were compared.Results A total of 72 patients were enrolled in this study, including 30 patients in the LPD group and 42 patients in the OPD group. There were no significant differences in the age, gender, and other baseline indicators between the two groups (P>0.05). Although the operative time of the LPD group was longer than that of the OPD group (P<0.05), the intraoperative blood loss in the LPD group was significantly less than that in the OPD group (P<0.05), the postoperative hospital stay, postoperative exhaust time, and postoperative ambulation time in the LPD group were shorter than those in the OPD group (P<0.05). And there were no significant differences in the terms of intraoperative red blood cell transfusion, intraoperative blood transfusion rate, postoperative ICU hospitalization time, hospitalization expenses, overall complications and specific complications (except incision infection rate of LPD group was significantly lower than OPD group, P=0.031) between the two groups (P>0.05). There were no significant differences in the positive rate of resection margin, number of lymph node dissection, and positive rate of lymph node between the two groups (P>0.05).Conclusion LPD has the same safety and effectiveness as OPD in the perioperative period in municipal hospitals, and is more conducive to postoperative recovery of patients.

Citation： JIANG Kangyi, GAO Fengwei, LEI Zehua, WU Jianping, FU Jinqiang, DU Bo, WANG Zhixu, XIE Qingyun, ZHOU Quanyu, GONG Jie, XUE Qian, ZHAO Xin. Comparative study of perioperative efficacy between laparoscopic and open pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(3): 345-349. doi: 10.7507/1007-9424.202008040 Copy

1.	彭兵, 王明俊. 腹腔镜胰十二指肠切除术的历史与现状. 中国普外基础与临床杂志, 2016, 23(4): 385-387.
2.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
3.	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.
4.	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.
5.	Ricci C, Casadei R, Taffurelli G, et al. Minimally invasive pancreaticoduodenectomy: What is the best “choice” ? A systematic review and network meta-analysis of non-randomized comparative studies. World J Surg, 2018, 42(3): 788-805.
6.	任芳, 金巍巍, 牟一平, 等. “Easy First”策略行腹腔镜胰十二指肠切除术治疗可能切除胰腺癌的临床疗效. 中华消化外科杂志, 2015, 14(8): 644-647.
7.	Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. surgery, 2017, 161(3): 584-591.
8.	中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺病专业委员会, 中华外科杂志编辑部. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 中华外科杂志, 2017, 55(5): 328-334.
9.	卢榜裕, 陆文奇, 蔡小勇, 等. 腹腔镜胰十二指肠切除治疗十二指肠乳头癌一例报告. 中国微创外科杂志, 2003, 3(3): 197-198.
10.	蔡云强, 彭兵. 浅谈如何安全度过腹腔镜胰十二指肠切除术学习曲线. 腹腔镜外科杂志, 2018, 23(5): 326-328.
11.	Boggi U, Amorese G, Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc, 2015, 29(1): 9-23.
12.	Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
13.	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): 146-155.
14.	刘学青, 邢中强, 秦建章, 等. 腹腔镜胰十二指肠切除术单中心 300 例临床分析. 中国实用外科杂志, 2018, 38(3): 306-311.
15.	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.
16.	Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg, 2015, 220(4): 530-536.
17.	Wang M, Peng B, Liu J, et al. Practice patterns and perioperative outcomes of laparoscopic pancreaticoduodenectomy in China: a retrospective multicenter analysis of 1 029 patients. Ann Surg, 2019: Jan 17.
18.	倪泉兴. 胰十二指肠切除术胰肠重建的基本要求和吻合方式选择. 中华肝胆外科杂志, 2011, 17(11): 876-878.
19.	洪德飞, 刘亚辉, 张宇华, 等. 腹腔镜胰十二指肠切除术中“洪氏一针法”胰管空肠吻合的临床应用. 中华外科杂志, 2017, 55(2): 136-140.
20.	高峰畏, 雷泽华, 龚杰, 等. “两点法”胰肠吻合方式在胰十二指肠切除术中应用的研究. 外科研究与新技术, 2019, 8(3): 151-153.
21.	中华外科杂志编辑部. 开放和腹腔镜手术中胰肠吻合方式专家谈. 中华外科杂志, 2018, 56(11): 817-821.
22.	唐雪琴, 苗毅. 胰肠吻合新的理解—从机械连接到生物愈合. 中国普通外科杂志, 2015, 24(9): 1213-1215.

1. 彭兵, 王明俊. 腹腔镜胰十二指肠切除术的历史与现状. 中国普外基础与临床杂志, 2016, 23(4): 385-387.
2. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
3. 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.
4. 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.
5. Ricci C, Casadei R, Taffurelli G, et al. Minimally invasive pancreaticoduodenectomy: What is the best “choice” ? A systematic review and network meta-analysis of non-randomized comparative studies. World J Surg, 2018, 42(3): 788-805.
6. 任芳, 金巍巍, 牟一平, 等. “Easy First”策略行腹腔镜胰十二指肠切除术治疗可能切除胰腺癌的临床疗效. 中华消化外科杂志, 2015, 14(8): 644-647.
7. Bassi C, Marchegiani G, Dervenis C, et al. The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. surgery, 2017, 161(3): 584-591.
8. 中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺病专业委员会, 中华外科杂志编辑部. 胰腺术后外科常见并发症诊治及预防的专家共识(2017). 中华外科杂志, 2017, 55(5): 328-334.
9. 卢榜裕, 陆文奇, 蔡小勇, 等. 腹腔镜胰十二指肠切除治疗十二指肠乳头癌一例报告. 中国微创外科杂志, 2003, 3(3): 197-198.
10. 蔡云强, 彭兵. 浅谈如何安全度过腹腔镜胰十二指肠切除术学习曲线. 腹腔镜外科杂志, 2018, 23(5): 326-328.
11. Boggi U, Amorese G, Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc, 2015, 29(1): 9-23.
12. Kim SC, Song KB, Jung YS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc, 2013, 27(1): 95-103.
13. 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): 146-155.
14. 刘学青, 邢中强, 秦建章, 等. 腹腔镜胰十二指肠切除术单中心 300 例临床分析. 中国实用外科杂志, 2018, 38(3): 306-311.
15. 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.
16. Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg, 2015, 220(4): 530-536.
17. Wang M, Peng B, Liu J, et al. Practice patterns and perioperative outcomes of laparoscopic pancreaticoduodenectomy in China: a retrospective multicenter analysis of 1 029 patients. Ann Surg, 2019: Jan 17.
18. 倪泉兴. 胰十二指肠切除术胰肠重建的基本要求和吻合方式选择. 中华肝胆外科杂志, 2011, 17(11): 876-878.
19. 洪德飞, 刘亚辉, 张宇华, 等. 腹腔镜胰十二指肠切除术中“洪氏一针法”胰管空肠吻合的临床应用. 中华外科杂志, 2017, 55(2): 136-140.
20. 高峰畏, 雷泽华, 龚杰, 等. “两点法”胰肠吻合方式在胰十二指肠切除术中应用的研究. 外科研究与新技术, 2019, 8(3): 151-153.
21. 中华外科杂志编辑部. 开放和腹腔镜手术中胰肠吻合方式专家谈. 中华外科杂志, 2018, 56(11): 817-821.
22. 唐雪琴, 苗毅. 胰肠吻合新的理解—从机械连接到生物愈合. 中国普通外科杂志, 2015, 24(9): 1213-1215.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Comparative study of perioperative efficacy between laparoscopic and open pancreaticoduodenectomy

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