AI Article Synopsis
- The study aimed to compare surgical and postoperative outcomes of laparoscopic pancreaticoduodenectomy (LPD) in patients with pancreatic cancer versus other periampullary neoplasms, using a right artery first approach.
- Data from 31 patients (15 with pancreatic cancer and 16 with other neoplasms) showed no significant differences in surgical times, blood loss, or pathological outcomes between the two groups.
- The only notable difference was a higher overall complication rate in patients with other periampullary neoplasms (68.7% vs. 26.7% in pancreatic cancer), suggesting the right artery first approach is feasible for both groups.
Article Abstract
Background: The most debated aspects of laparoscopic pancreaticoduodenectomy (LPD) concern the dissection of the pancreas from the surrounding vessels and the achievement of adequate resection margins, especially in patients with pancreatic cancer.
Methods: Data of consecutive patients undergoing LPD with right artery first approach from September 2020 to September 2021 for periampullary neoplasms (pancreatic, ampullary, duodenal, distal common biliary duct) were prospectively collected and retrospectively analyzed. The overall cohort was divided into two groups: patients affected by pancreatic carcinoma (PC) and patients affected by other periampullary neoplasms (OP). Surgical and postoperative outcomes between PC and OP were compared.
Results: Thirty-one patients (15 PC and 16 OP) were selected. No difference was found between PC and OP in terms of baseline characteristics. Median resection time and overall surgical time of the entire cohort were 275 min and 530 min, respectively, without difference between the groups (p = 0.599 and 0.052, respectively). Blood loss was similar between the groups, being 350 ml in PC and 325 ml in OP (p = 0.762). One patient (3.2%) was converted to laparotomy. No difference was found between the groups in terms of pathological outcomes. Median number of retrieved lymph nodes was 17. The majority of the patients (83.9%) received an R0 resection (73.3% and 93.7% in PC and OP, respectively; p = 0.172). Postoperative surgical outcomes did not differ between the groups, excepting for overall complication rate that was higher in the OP group (26.7% vs 68.7% in PC and OP, respectively; p = 0.032).
Conclusion: Standardized right artery first approach during LPD was feasible and did not show worse surgical and postoperative outcomes in patients with pancreatic cancer as compared to those affected by other periampullary neoplasms, except for a higher rate of minor complications.
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| http://dx.doi.org/10.1007/s00464-022-09494-2 | DOI Listing |
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