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Preliminary results of laparoscopic versus open pancreaticoduodenectomy in Vietnam: A retrospective analysis from a multi-center research
Institution:1. Department of Surgery, Hanoi Medical University, No. 1 Ton That Tung, Dong Da District, Hanoi, Viet Nam;2. General Surgery Department, Bachmai Hospital, No. 78 Giaiphong Road, Dong Da District, Hanoi, Viet Nam;3. Department of Surgery, Phu Tho Provincial Hospital, Nguyen Tat Thanh Road, Viet Tri Town, Phu Tho Province, Viet Nam;4. Laparoscopic Surgical Centre, Vietduc University Hospital, No. 40 Trang Thi, Hoan Kiem District, Hanoi, Viet Nam;5. Department of Surgery, Military Medical University, No. 160 Phung Hung, Phuc La Ward, Ha Dong District, Hanoi, Viet Nam;6. Center for Digestive Surgery, 103 Military Hospital, No. 160 Phung Hung, Phuc La Ward, Ha Dong District, Hanoi, Viet Nam;7. Department of Pharmacy, Bachmai Hospital, 78 Giaiphong Road, Dong Da District, Hanoi, Viet Nam;8. Organ Transplantation Center, Vietduc University Hospital, 40 Trang Thi, Hoan Kiem District, Hanoi, Viet Nam
Abstract:IntroductionThe goal of this study was to compare the results of LPD with those of open pancreaticoduodenectomy (OPD).MethodData were retrospectively collected from a database of patients who underwent PD from January 2010 to May 2020. Intraoperative, postoperative, and follow-up assessment studies were conducted.ResultsA total of 149 patients were selected. Compared with OPD, LPD was fewer intraoperative blood transfusions (p = 0.015), a longer median operative time (p < 0.001), hospital stay (p = 0.034), a higher rate of bile leakage (p = 0.02), overall morbidity (p = 0.045), and re-operation (p = 0.044). There was no difference between the two groups in severe pancreatic fistula, postoperative bleeding, delayed gastric emptying, Clavien-Dindo classification ≥ III, or 30-day mortality. LPD had a similar number of excised lymph nodes, R0 resection rate, and long-term survival cases involving malignant tumors, ampulla of Vater cancer, and pancreatic ductal adenocarcinoma.ConclusionIn the early period, the benefit of LPD has not been found as there was a high rate of conversion to laparotomy, morbidity, and re-operation. Despite that, LPD is a feasible oncological approach with long-term survival comparable to OPD.
Keywords:Pancreatic neoplasms  Laparoscopic  Pancreaticoduodenectomy  Open surgery  Overall survival
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