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Comparison of prognosis and postoperative morbidities between standard pancreaticoduodenectomy and the TRIANGLE technique for resectable pancreatic ductal adenocarcinoma. | LitMetric
Division of Pancreatic Surgery, Department of General Surgery, Nanjing Drum Tower Hospital, The Affiliated Hospital of Medical School, Nanjing University, Nanjing 210008, Jiangsu Province, China.
Published: March 2024
AI Article Synopsis
Article Abstract
Background: Radical surgery combined with systemic chemotherapy offers the possibility of long-term survival or even cure for patients with pancreatic ductal adenocarcinoma (PDAC), although tumor recurrence, especially locally, still inhibits the treatment efficacy. The TRIANGLE technique was introduced as an extended dissection procedure to improve the R0 resection rate of borderline resectable or locally advanced PDAC. However, there was a lack of studies concerning postoperative complications and long-term outcomes of this procedure on patients with resectable PDAC.
Aim: To compare the prognosis and postoperative morbidities between standard pancreaticoduodenectomy (PD) and the TRIANGLE technique for resectable PDAC.
Methods: Patients with resectable PDAC eligible for PD from our hospital between June 2018 and December 2021 were enrolled in this retrospective cohort study. All the patients were divided into PD and PD groups according to the surgical procedure. Baseline characteristics, surgical data, and postoperative morbidities were recorded. All of the patients were followed up, and the date and location of tumor recurrence, and death were recorded. The Kaplan-Meier method and log-rank test were used for the survival analysis.
Results: There were 93 patients included in the study and 37 underwent the TRIANGLE technique. Duration of operation was longer in the PD group compared with the PD group [440 (410-480) min 320 (265-427) min] ( = 0.001). Intraoperative blood loss [700 (500-1200) mL 500 (300-800) mL] ( = 0.009) and blood transfusion [975 (0-1250) mL 400 (0-800) mL] ( = 0.009) were higher in the PD group. There was a higher incidence of surgical site infection (43.2% 12.5%) ( = 0.001) and postoperative diarrhea (54.1% 12.5%) ( = 0.001) in the PD group. The rates of R0 resection and local recurrence, overall survival, and disease-free survival did not differ significantly between the two groups.
Conclusion: The TRIANGLE technique is safe, with acceptable postoperative morbidities compared with standardized PD, but it does not improve prognosis for patients with resectable PDAC.
