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Propensity score‐matched analysis of early outcomes after laparoscopic‐assisted versus open pancreaticoduodenectomy
Author(s) -
Tan Jarrod K. H.,
Ng Jun Jie,
Yeo Melissa,
Koh Frederick H. X.,
Bonney Glenn K.,
Ganpathi Iyer S.,
Madhavan Krishnakumar,
Kow Alfred W. C.
Publication year - 2019
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.15124
Subject(s) - medicine , pancreaticoduodenectomy , surgery , body mass index , retrospective cohort study , resection
Background Minimally invasive pancreaticoduodenectomy (PD) is a feasible option for periampullary tumours. However, it remains a complex procedure with no proven advantages over open PD (OPD). The aim of the study was to compare the outcomes between laparoscopic‐assisted PD (LAPD) and OPD using a propensity score‐matched analysis. Methods Retrospective review of 40 patients who underwent PD for periampullary tumours between January 2014 and December 2016 was conducted. The patients were matched 1:1 for age, gender, body mass index, Charlson comorbidty index, tumour size and haematological indices. Peri‐operative outcomes were evaluated. Results LAPD appeared to have a longer median operative time as compared to OPD (LAPD, 425 min (285–597) versus OPD, 369 min (260–500)) ( P = 0.066). Intra‐operative blood loss was comparable between both groups. Respiratory complications were five times higher in the OPD group (LAPD, 5% versus OPD, 25%) ( P = 0.077), while LAPD patients required less time to start ambulating post‐operatively (LAPD, 2 days versus OPD, 2 days) ( P = 0.021). Pancreas‐specific complications and morbidity/mortality rates were similar. Conclusion LAPD is a safe alternative to OPD in a select group of patients for an institution starting out with minimally invasive PD, and can be used to bridge the learning curve required for total laparoscopic PD.