Minimally invasive versus open pancreatoduodenectomy for pancreatic ductal adenocarcinoma: Individual patient data meta-analysis of randomized trials

Uijterwijk, Bas; Wei, Kongyuan; Kasai, Meidai; Ielpo, Benedetto; Hilst, Jony van; Palanivelu, Chinnusamy; Lemmers, Daniel H.L.; Burdı́o, Fernando; Senthilnathan, Palanisamy; Besselink, Marc G.; Hilal, Mohammed Abu; Qin, Renyi

doi:10.1016/j.ejso.2023.03.227

Cited by 1 publication

(1 citation statement)

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“…All patients with an indication for elective LPD will be evaluated. The reasons for laparoscopic approach is the only choice for this trial but not open or robotic are as follows: there are many aspects that differ between open and minimally invasive (laparoscopic and robotic) pancreaticoduodenectomy, including some of the postoperative complications, duration of surgery, intraoperative bleeding, length of hospitalisation and so on 15–18. And it is still up for debate to choose the approach.…”

Section: Methods and Analysismentioning

confidence: 99%

Extended pancreatic neck transection versus conventional pancreatic neck transection during laparoscopic pancreaticoduodenectomy (LPDEXCEPT): protocol for a multicentre superiority randomised controlled trial

You,

Zhang,

Cai

et al. 2024

BMJ Open

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IntroductionPostoperative pancreatic fistula (POPF) remains one of the most severe complications of laparoscopic pancreaticoduodenectomy (LPD). Theoretically, transecting the pancreatic neck more distally has both advantages (more blood supply, and more central pancreatic duct) and disadvantages (maybe smaller the pancreatic duct) in preventing POPF. This theoretical contradiction pushed us to organise this trial to explore the impact of the level of pancreatic transection in clinical practice. We conduct this randomised trial with the hypothesis that extended pancreatic neck transection has superiority to conventional pancreatic neck transection.Methods and analysisThe LPDEXCEPT (Extended pancreatic neck transection versus conventional pancreatic neck transection during laparoscopic pancreaticoduodenectomy) trial is a multicentre, randomised-controlled, open-label, superiority trial in 4 centres whose annual surgical volume for LPD is more than 25 cases with pancreatic surgeons who had completed their learning curve. A total of 154 patients who meet the inclusive and exclusive criteria are randomly allocated to the extended pancreatic neck transection group or conventional pancreatic neck transection group in a 1:1 ratio. The stratified randomised block design will be applied, with stratified factors are surgical centre and the diameter of the main pancreatic duct measured by preoperative CT scan (preMPD). The primary outcome is the incidence of the clinically relevant pancreatic fistula.Ethics and disseminationEthics Committee on Biomedical Research of West China Hospital of Sichuan University has approved this trial in March 2023 (approval no. 2023-167). Results of this trial will be published in peer-reviewed journals and conference proceedings.Trial registration numberNCT05808894.

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Section: Methods and Analysismentioning

confidence: 99%