Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study
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 sum...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-01-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12957-023-02909-x |
| _version_ | 1811171693370015744 |
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| author | Bin Zhang Zipeng Xu Weifang Gu Junjing Zhou Neng Tang Shuo Zhang Chaobo Chen Zhongjun Zhang |
| author_facet | Bin Zhang Zipeng Xu Weifang Gu Junjing Zhou Neng Tang Shuo Zhang Chaobo Chen Zhongjun Zhang |
| author_sort | Bin Zhang |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-04-10T17:18:16Z |
| format | Article |
| id | doaj.art-5cee5685a89f48b18cd0857ffb32faef |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-04-10T17:18:16Z |
| publishDate | 2023-01-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-5cee5685a89f48b18cd0857ffb32faef2023-02-05T12:14:42ZengBMCWorld Journal of Surgical Oncology1477-78192023-01-012111910.1186/s12957-023-02909-xPostoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort studyBin Zhang0Zipeng Xu1Weifang Gu2Junjing Zhou3Neng Tang4Shuo Zhang5Chaobo Chen6Zhongjun Zhang7Department of Anesthesiology, The Affiliated Hospital of Jiangnan UniversityDepartment of General Surgery, Xishan People’s Hospital of Wuxi CityDepartment of Laboratory, The Affiliated Hospital of Jiangnan UniversityDepartment of Hepatic-Biliary-Pancreatic Surgery, The Affiliated Hospital of Jiangnan UniversityDepartment of Hepatic-Biliary-Pancreatic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical SchoolDepartment of Hepatic-Biliary-Pancreatic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical SchoolDepartment of General Surgery, Xishan People’s Hospital of Wuxi CityDepartment of Anesthesiology, The Affiliated Hospital of Jiangnan UniversityAbstract 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.https://doi.org/10.1186/s12957-023-02909-xPancreaticoduodenectomyPancreatic adenocarcinomaLaparoscopyChinaRetrospective study |
| spellingShingle | Bin Zhang Zipeng Xu Weifang Gu Junjing Zhou Neng Tang Shuo Zhang Chaobo Chen Zhongjun Zhang Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study World Journal of Surgical Oncology Pancreaticoduodenectomy Pancreatic adenocarcinoma Laparoscopy China Retrospective study |
| title | Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study |
| title_full | Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study |
| title_fullStr | Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study |
| title_full_unstemmed | Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study |
| title_short | Postoperative complications and short-term prognosis of laparoscopic pancreaticoduodenectomy vs. open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma: a retrospective cohort study |
| title_sort | postoperative complications and short term prognosis of laparoscopic pancreaticoduodenectomy vs open pancreaticoduodenectomy for treating pancreatic ductal adenocarcinoma a retrospective cohort study |
| topic | Pancreaticoduodenectomy Pancreatic adenocarcinoma Laparoscopy China Retrospective study |
| url | https://doi.org/10.1186/s12957-023-02909-x |
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