Palanivelu C, et al. - This randomized clinical trial was planned to compare laparoscopic and open pancreatoduodenectomy for short-term outcomes. Findings revealed that laparoscopy offered a shorter hospital stay than open pancreatoduodenectomy.

Methods

• Authors randomized patients with periampullary cancers to either laparoscopic or open pancreatoduodenectomy.
• Evaluation was performed of outcomes including hospital stay (primary outcome), and blood loss, radicality of surgery, duration of operation and complication rate (secondary outcomes).

Results

• Of 268 patients, randomization was performed of 64 patients who met the eligibility criteria, 32 to each group.
• In this study, longer median duration of postoperative hospital stay was observed for open pancreaticoduodenectomy than for laparoscopy (13 (range 6–30) versus 7 (5–52) days respectively; P = 0·001).
• Longer duration of operation was observed in the laparoscopy group.
• The open group indicated significantly greater blood loss (mean(s.d.) 401(46) versus 250(22) ml; P < 0·001).
• The two groups were similar regarding number of nodes retrieved and R0 rate.
• The open and laparoscopic groups were similar regarding delayed gastric emptying (7 of 32 versus 5 of 32), pancreatic fistula (6 of 32 versus 5 of 32) or postpancreatectomy haemorrhage (4 of 32 versus 3 of 32).
• Overall complications (defined according to the Clavien–Dindo classification) were similar (10 of 32 versus 8 of 32).
• Authors observed one death in each group.