Olga Kantor1, Mark S Talamonti2, Susan Sharpe3, Waseem Lutfi4, David J Winchester2, Kevin K Roggin5, David J Bentrem6, Richard A Prinz2, Marshall S Baker7. 1. Department of Surgery, University of Chicago, Chicago, IL, United States. 2. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States. 3. Department of Surgery, University of Chicago, Chicago, IL, United States; Department of Surgery, MetroHealth Medical Center, Cleveland, OH, United States. 4. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States. 5. Department of Surgery, University of Chicago, Chicago, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States. 6. Department of Surgery, Northwestern University, Chicago, IL, United States. 7. Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States. Electronic address: Mbaker3@northshore.org.
Abstract
BACKGROUND: The long-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) relative to open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma has not been well studied. METHODS: The National Cancer Data Base was used to compare patients undergoing LPD and OPD for stage I-II pancreatic adenocarcinoma between 2010 and 2013. RESULTS: 828 (10%) patients underwent LPD and 7385 (90%) OPD. There were no differences in tumor or demographic characteristics between groups. On multivariable analysis adjusted for hospital volume, LPD was associated with a lower rate of readmission (p < 0.01) and trends toward shorter initial length of stay (p = 0.14) and time to adjuvant chemotherapy (p = 0.11). There were no differences between patients undergoing LPD and those undergoing OP in rates of margin negative resection, number of lymph nodes examined, perioperative mortality and median overall survival (20.7 vs 20.9 months, p = 0.68). CONCLUSIONS: For patients with localized pancreatic adenocarcinoma, LPD provides short-term oncologic and long-term overall survival outcomes identical to OPD and is associated with decreased rates of readmission and a trend towards accelerated recovery.
BACKGROUND: The long-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) relative to open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma has not been well studied. METHODS: The National Cancer Data Base was used to compare patients undergoing LPD and OPD for stage I-II pancreatic adenocarcinoma between 2010 and 2013. RESULTS: 828 (10%) patients underwent LPD and 7385 (90%) OPD. There were no differences in tumor or demographic characteristics between groups. On multivariable analysis adjusted for hospital volume, LPD was associated with a lower rate of readmission (p < 0.01) and trends toward shorter initial length of stay (p = 0.14) and time to adjuvant chemotherapy (p = 0.11). There were no differences between patients undergoing LPD and those undergoing OP in rates of margin negative resection, number of lymph nodes examined, perioperative mortality and median overall survival (20.7 vs 20.9 months, p = 0.68). CONCLUSIONS: For patients with localized pancreatic adenocarcinoma, LPD provides short-term oncologic and long-term overall survival outcomes identical to OPD and is associated with decreased rates of readmission and a trend towards accelerated recovery.
Authors: Andrew A Gumbs; Elie Chouillard; Mohamed Abu Hilal; Roland Croner; Brice Gayet; Michel Gagner Journal: Surg Endosc Date: 2020-11-04 Impact factor: 4.584