Minimally invasive versus classical pancreaticoduodenectomy: our preliminary results
EAES Academy. Marques T. 07/05/22; 363079; P124
Dra Tatiana Marques
Contributions
Contributions
Abstract
Aims:
Pancreaticoduodenectomy is one of the most complex surgical procedures currently performed. Despite becoming increasingly safer in the last decades, its morbidity remains high. Regardless of minimally invasive surgery being the standard of care in many areas, considering pancreaticoduodenectomy (PD), the classical approach is still what prevails. Here we present our preliminary results comparing open and laparoscopic approaches for PD.
Methods:
We collected data from the electronic medical record of all patients that underwent PD in our centre between January 2015 and December 2021. Statistical analysis was made using IBM SPSS and for all tests a p-value <0,05 was considered statistically significant. A retrospective analysis was made including patients` clinical characteristics and comparing open and laparoscopic PD`s short term outcomes.
Results:
A total of 66 patients, mean age of 70 years old, were included in the study, 29 of which had minimally invasive surgery (44%). Laparoscopic conversion rate was 24,1% (7/29). The median length of surgery was 6 hours in the open surgery group and 8 hours in the laparoscopic group (p<0,05). Median blood loss was 400mL in the open group versus 700mL in the laparoscopic (p=0,07), mainly due to surgeries needing conversion. Total laparoscopic PD`s median blood loss was 400mL. C grade pancreatic fistula rates weren`t different between groups (13% open vs 10% laparoscopic), neither were the reoperation rate (p=0,239), nor the median length of stay (26 days for both approaches). 30-day mortality rate was 5,4% in the classical approach group versus 3,7% in the minimally invasive one.
Conclusion:
Our early results show no differences in the safety of the laparoscopic procedure when compared to the open approach, as the median blood loss, C level pancreatic fistula, reoperation and 30-day mortality rates were not statistically different. Improving the learning curve in laparoscopic PD might significantly improve clinical outcomes.
Pancreaticoduodenectomy is one of the most complex surgical procedures currently performed. Despite becoming increasingly safer in the last decades, its morbidity remains high. Regardless of minimally invasive surgery being the standard of care in many areas, considering pancreaticoduodenectomy (PD), the classical approach is still what prevails. Here we present our preliminary results comparing open and laparoscopic approaches for PD.
Methods:
We collected data from the electronic medical record of all patients that underwent PD in our centre between January 2015 and December 2021. Statistical analysis was made using IBM SPSS and for all tests a p-value <0,05 was considered statistically significant. A retrospective analysis was made including patients` clinical characteristics and comparing open and laparoscopic PD`s short term outcomes.
Results:
A total of 66 patients, mean age of 70 years old, were included in the study, 29 of which had minimally invasive surgery (44%). Laparoscopic conversion rate was 24,1% (7/29). The median length of surgery was 6 hours in the open surgery group and 8 hours in the laparoscopic group (p<0,05). Median blood loss was 400mL in the open group versus 700mL in the laparoscopic (p=0,07), mainly due to surgeries needing conversion. Total laparoscopic PD`s median blood loss was 400mL. C grade pancreatic fistula rates weren`t different between groups (13% open vs 10% laparoscopic), neither were the reoperation rate (p=0,239), nor the median length of stay (26 days for both approaches). 30-day mortality rate was 5,4% in the classical approach group versus 3,7% in the minimally invasive one.
Conclusion:
Our early results show no differences in the safety of the laparoscopic procedure when compared to the open approach, as the median blood loss, C level pancreatic fistula, reoperation and 30-day mortality rates were not statistically different. Improving the learning curve in laparoscopic PD might significantly improve clinical outcomes.
Aims:
Pancreaticoduodenectomy is one of the most complex surgical procedures currently performed. Despite becoming increasingly safer in the last decades, its morbidity remains high. Regardless of minimally invasive surgery being the standard of care in many areas, considering pancreaticoduodenectomy (PD), the classical approach is still what prevails. Here we present our preliminary results comparing open and laparoscopic approaches for PD.
Methods:
We collected data from the electronic medical record of all patients that underwent PD in our centre between January 2015 and December 2021. Statistical analysis was made using IBM SPSS and for all tests a p-value <0,05 was considered statistically significant. A retrospective analysis was made including patients` clinical characteristics and comparing open and laparoscopic PD`s short term outcomes.
Results:
A total of 66 patients, mean age of 70 years old, were included in the study, 29 of which had minimally invasive surgery (44%). Laparoscopic conversion rate was 24,1% (7/29). The median length of surgery was 6 hours in the open surgery group and 8 hours in the laparoscopic group (p<0,05). Median blood loss was 400mL in the open group versus 700mL in the laparoscopic (p=0,07), mainly due to surgeries needing conversion. Total laparoscopic PD`s median blood loss was 400mL. C grade pancreatic fistula rates weren`t different between groups (13% open vs 10% laparoscopic), neither were the reoperation rate (p=0,239), nor the median length of stay (26 days for both approaches). 30-day mortality rate was 5,4% in the classical approach group versus 3,7% in the minimally invasive one.
Conclusion:
Our early results show no differences in the safety of the laparoscopic procedure when compared to the open approach, as the median blood loss, C level pancreatic fistula, reoperation and 30-day mortality rates were not statistically different. Improving the learning curve in laparoscopic PD might significantly improve clinical outcomes.
Pancreaticoduodenectomy is one of the most complex surgical procedures currently performed. Despite becoming increasingly safer in the last decades, its morbidity remains high. Regardless of minimally invasive surgery being the standard of care in many areas, considering pancreaticoduodenectomy (PD), the classical approach is still what prevails. Here we present our preliminary results comparing open and laparoscopic approaches for PD.
Methods:
We collected data from the electronic medical record of all patients that underwent PD in our centre between January 2015 and December 2021. Statistical analysis was made using IBM SPSS and for all tests a p-value <0,05 was considered statistically significant. A retrospective analysis was made including patients` clinical characteristics and comparing open and laparoscopic PD`s short term outcomes.
Results:
A total of 66 patients, mean age of 70 years old, were included in the study, 29 of which had minimally invasive surgery (44%). Laparoscopic conversion rate was 24,1% (7/29). The median length of surgery was 6 hours in the open surgery group and 8 hours in the laparoscopic group (p<0,05). Median blood loss was 400mL in the open group versus 700mL in the laparoscopic (p=0,07), mainly due to surgeries needing conversion. Total laparoscopic PD`s median blood loss was 400mL. C grade pancreatic fistula rates weren`t different between groups (13% open vs 10% laparoscopic), neither were the reoperation rate (p=0,239), nor the median length of stay (26 days for both approaches). 30-day mortality rate was 5,4% in the classical approach group versus 3,7% in the minimally invasive one.
Conclusion:
Our early results show no differences in the safety of the laparoscopic procedure when compared to the open approach, as the median blood loss, C level pancreatic fistula, reoperation and 30-day mortality rates were not statistically different. Improving the learning curve in laparoscopic PD might significantly improve clinical outcomes.
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