Pancreatic Neoplasms
Conditions
Keywords
pancreatoduodenectomy, minimally-invasive surgery, pancreatic cancer, chronic pancreatitis
Brief summary
Minimally invasive pancreatoduodenectomy is increasingly performed. However, technical challenges and a perceived higher risk of complications has hindered wide adoption of a minimally invasive approach. This is a retrospective comparison of a prospectively kept database. The investigators compared surgical outcomes and survival after laparoscopic (LPD) versus open pancreatoduodenectomy (OPD). In order to reduce the effect of bias and confounding, baseline characteristics of both groups were matched using propensity score matching.
Detailed description
All pancreatoduodenectomies were retrieved from a prospectively kept database and retrospectively analysed. All procedures were performed in a single supra-regional Belgian centre. The primary endpoint was the major complication rate, defined by a Clavien-Dindo morbidity classification grade IIIa or higher \[11\]. Secondary endpoints were 90-day mortality rate, length of hospital stay, operative time, blood loss, transfusion requirements and specific pancreatic complications (pancreatic fistula, haemorrhage, and delayed gastric emptying). In addition, overall survival (OS) and disease-free survival (DFS) were analysed in the subgroups of cancer patients.
Interventions
PROCEDUREpancreatoduodenectomy
Patients included in the cohorts all underwent pancreatoduodenectomy, open or laparoscopic
Sponsors
General Hospital Groeninge
Study design
Observational model
CASE_CONTROL
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* diagnosis of lesion of pancreatic head or peri-ampullary organs
Exclusion criteria
* \< 18 years old
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Major complication rate | 90 days postoperative | Complications classified as morbidity classification 3a or greater (Clavien-Dindo) |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Short-term postoperative outcomes | Up to 30 days | Hospital stay (days), drain in situ (days), ICU stay (days) |
| Postoperative morbidity | 90 days | All complications classified as morbidity classification 3a or greater (Clavien-Dindo) |
| Perioperative outcomes | Up to 30 days | Operative time (min), blood transfusion requirements, estimated blood loss (mL) |
| Overall survival and disease-free survival | Up to 20 years | The Kaplan-Meier method was used for estimation of survival and compared between subgroups of cancer patients |
| Oncological outcomes | Up to 20 years | Analysis of resection specimen following contemporary pathlogy guidelines and defined by TNM staging system of pancreatic cancer by AJCC/UICC. |
| Pancreatectomy-specific complications | 90 days | Postoperative pancreatic fistula, Post-pancreatectomy haemorrhage, delayed gastric emptying, as defined by the respective ISGPS classification |
Countries
Belgium
Outcome results
None listed