Highs and lows in laparoscopic pancreaticoduodenectomy

Espín, Francisco; Domingo, María Isabel García; Pérez, Manel Cremades; Fonollosa, Eric Herrero; López, J.; Lasa, Judith Camps; Aranda, Fernando; Andorrà, Esteban Cugat

doi:10.1016/j.cireng.2021.08.001

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…Previous cohort studies support our observation that laparoscopic surgery generally entails shorter operative time compared to robotic surgery [9,11,24,31,32]. One potential factor contributing to this observation is the lack of a clear distinction between effective operative time and docking time in the robotic approach.…”

Section: Discussionsupporting

confidence: 56%

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Acciuffi,

Hilal,

Ferrari

et al. 2024

Cancers

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Background: Minimally invasive surgery is increasingly preferred for left-sided pancreatic resections. The SIMPLR study aims to compare open, laparoscopic, and robotic approaches using propensity score matching analysis. Methods: This study included 258 patients with tumors of the left side of the pancreas who underwent surgery between 2016 and 2020 at three high-volume centers. The patients were divided into three groups based on their surgical approach and matched in a 1:1 ratio. Results: The open group had significantly higher estimated blood loss (620 mL vs. 320 mL, p < 0.001), longer operative time (273 vs. 216 min, p = 0.003), and longer hospital stays (16.9 vs. 6.81 days, p < 0.001) compared to the laparoscopic group. There was no difference in lymph node yield or resection status. When comparing open and robotic groups, the robotic procedures yielded a higher number of lymph nodes (24.9 vs. 15.2, p = 0.011) without being significantly longer. The laparoscopic group had a shorter operative time (210 vs. 340 min, p < 0.001), shorter ICU stays (0.63 vs. 1.64 days, p < 0.001), and shorter hospital stays (6.61 vs. 11.8 days, p < 0.001) when compared to the robotic group. There was no difference in morbidity or mortality between the three techniques. Conclusion: The laparoscopic approach exhibits short-term benefits. The three techniques are equivalent in terms of oncological safety, morbidity, and mortality.

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Section: Discussionsupporting

confidence: 56%

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Acciuffi,

Hilal,

Ferrari

et al. 2024

Cancers

View full text Add to dashboard Cite

show abstract

“…Pancreaticoduodenectomy (PD), as a preferred treatment for malignant diseases of the head of pancreas, distal bile duct and periampullary. In contrast, greater advantages have been reported of laparoscopic surgery over PD (1)(2)(3). Despite the significant modifications in medical technology, the complication rates are still reported to be around 50% (4-7) in high volume centers, which has prolonged hospital stays, bringing mental burden to patients and aggravate health care costs.…”

Section: Introductionmentioning

confidence: 99%

Application of Clavien–Dindo classfication-grade in evaluating overall efficacy of laparoscopic pancreaticoduodenectomy

Song

Shi

et al. 2023

Front. Surg.

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BackgroundThe Clavien–Dindo classification (CDC) has been widely accepted and applied in clinical practice. We investigated its effectiveness in prediction of major complications (LPPC) after laparoscopic pancreaticoduodenectomy (LPD) and associated risk factors.MethodsA retrospective analysis was conducted covering clinical data of 793 patients undergoing LPD from April 2015 to November 2021. CDC was utilized to grade postoperative complications and analyze the differences. Risk factors of LPPC were identified according to univariate and multivariate analyses.ReslutsFor the 793 patients undergoing laparoscopic pancreaticoduodenectomy in the northeast of China, LPPC was reported in 260 (32.8%) patients, pancreatic fistula in 169 (21.3%), biliary fistula in 44 (5.5%), delayed gastric emptying in 17(2.1%), post pancreatectomy hemorrhage in 55 (6.9%), intestinal fistula in 7 (0.8%), abdominal infections in 59 (7.4%) and pulmonary complication in 28 (3.5%). All complications were classified into five levels with the C–D classification (Grade I–V), with 83 (31.9%) patients as grade I, 91 (35.0%) as grade II, 38 (14.6%) as grade IIIa, 24 (9.2%) as grade IIIb, 9 (3.5%) as grade IV and 15 (5.8%) as grade V. 86 (10.8%) patients experienced major complications (grade III–V).The results of univariate and multivariate analysis revealed the independent risk factors for laparoscopic pancreaticoduodenectomy complications to be preoperative total bilirubin (P = 0.029, OR = 1.523), soft pancreas texture (P < 0.001, OR = 1.399), male (P = 0.038, OR = 1.396) and intraoperative transfusion (P = 0.033, OR = 1.517). Preoperative total bilirubin (P = 0.036, OR = 1.906) and intraoperative transfusions (P = 0.004, OR = 2.123) were independently associated with major postoperative complications. The influence of different bilirubin levels on C–D grade of complications was statistically significant (P = 0.036, OR = 1.906).ConclusionsThe Clavien–Dindo classification (CDC) may serve as a valid tool to predict major postoperative complications and contribute to perioperative management and comparison of surgical techniques in different medical centers.

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Predictors of postoperative complications and readmissions in laparoscopic pancreas resection: Results of a cohort 105 consecutive cases. A retrospective study

Cienfuegos

Hurtado-Pardo

Breeze

et al. 2023

Cirugía Española (English Edition)

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Highs and lows in laparoscopic pancreaticoduodenectomy

Cited by 3 publications

References 27 publications

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Study International Multicentric Pancreatic Left Resections (SIMPLR): Does Surgical Approach Matter?

Application of Clavien–Dindo classfication-grade in evaluating overall efficacy of laparoscopic pancreaticoduodenectomy

Predictors of postoperative complications and readmissions in laparoscopic pancreas resection: Results of a cohort 105 consecutive cases. A retrospective study

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