Chen XM, et al. - Researchers performed a comparison of the perioperative outcomes of laparoscopic pancreaticoduodenectomy (LPD) vs open pancreaticoduodenectomy (OPD) in terms of feasibility, safety, and efficacy using the uncinate process–first approach. They noted that LPD with the uncinate process–first approach combined the benefits of laparoscopy with a low risk of postoperative complications and high rate of curative resection.

Methods

• Researchers performed a retrospective study of 102 patients who underwent pancreaticoduodenectomy between 2013 and 2017.
• Based on the surgical approach, they divided patients into two groups: the laparoscopic surgery group (n = 47) and open surgery group (n = 55).
• Retrospective analysis of clinical characteristics and intra- and postoperative data was performed.

Results

• In all 47 patients, LPD was performed successfully.
• The LPD group had significantly longer mean operation time (410 ± 68 min) than the OPD group (245 ± 70 min; P < 0.05).
• LPD resulted in markedly less intraoperative blood loss (210 ± 46 mL vs 420 ± 50 mL, P < 0.05), shorter first flatus time (1.5 d vs 4 d, P < 0.05) and shorter diet start time (2 d vs 5 d, P < 0.05).
• In the LPD group, the total hospital stay was significantly shorter, with a median of 13 ± 4 days vs 18 ± 5.5 days in the OPD group (P < 0.05).
• The LPD group and OPD group had the postoperative complication rates of 21.3% and 27.3%, respectively (P > 0.05).
• No significant differences were observed in the rate of category I–II complications and rate of category III–IV complications (P > 0.05).
• Researchers observed occurrence of pancreatic fistulae in 6 patients (12.8%) in the LPD group and 8 patients (14.5%) in the OPD group (P=0.67).
• Delayed gastric emptying was noted in 2 patients (4.26%) in the LPD group and 2 patients in the OPD group (3.63%; P=0.79).
• The groups showed no significant differences in postpancreatectomy haemorrhage (2.13% vs 3.63%; P=0.66).