The Yonsei experience of 104 laparoscopic pancreaticoduodenectomies: a propensity score-matched analysis with open pancreaticoduodenectomy

Sang Hyup Han, Chang Moo Kang, Ho Kyoung Hwang, Dong Sup Yoon, Woo Jung Lee

Research output: Contribution to journalArticle

Abstract

Background: With continued technical advances in surgical instruments and growing expertise, several surgeons have performed laparoscopic pylorus preserving pancreaticoduodenectomy (L-PPPD) safely with good results, and the laparoscopic approach is being performed more frequently. We performed over 100 cases of L-PPPD and compared their outcomes to those of open PPPD (O-PPPD) using the large sample size. The aim of the present study was to evaluate the safety and feasibility of L-PPPD compared with O-PPPD. Methods: From September 2012 to June 2017, PPPD was performed for 217 patients at Yonsei University Severance Hospital by a single surgeon. Patients were divided into two groups: those who underwent O-PPPD (n = 113) and those who underwent L-PPPD (n = 104). We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographic and surgical outcomes. We also reviewed all previous studies of more than 100 cases. Results: The L-PPPD group had lesser intraoperative blood loss than the O-PPPD group (548.1 ml vs. 244.7 ml; p < 0.001). Both groups showed similar rates of negative resection margins (99.1% vs. 96.2%; p = 0.196). Overall complication rates did not differ significantly between O-PPPD and L-PPPD (39.8% vs. 35.6%; p = 0.519). The clinically relevant postoperative pancreatic fistula (POPF) rates in the O-PPPD and L-PPPD groups were 18.8% and 13.5%, respectively (p = 0.311). There was no difference in 30- and 90-day mortality rates between the two groups (p = 0.479). Similar results were obtained after PSM analysis. Conclusions: L-PPPD can be a good alternative option for well-selected patients with periampullary lesions requiring PPPD.

Original languageEnglish
JournalSurgical endoscopy
DOIs
Publication statusPublished - 2019 Jan 1

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Propensity Score
Pancreaticoduodenectomy
Pylorus
Pancreatic Fistula
Surgical Instruments
Sample Size
Demography
Safety
Mortality

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{041d47dcb17d410d9d6d6c72d986a85f,
title = "The Yonsei experience of 104 laparoscopic pancreaticoduodenectomies: a propensity score-matched analysis with open pancreaticoduodenectomy",
abstract = "Background: With continued technical advances in surgical instruments and growing expertise, several surgeons have performed laparoscopic pylorus preserving pancreaticoduodenectomy (L-PPPD) safely with good results, and the laparoscopic approach is being performed more frequently. We performed over 100 cases of L-PPPD and compared their outcomes to those of open PPPD (O-PPPD) using the large sample size. The aim of the present study was to evaluate the safety and feasibility of L-PPPD compared with O-PPPD. Methods: From September 2012 to June 2017, PPPD was performed for 217 patients at Yonsei University Severance Hospital by a single surgeon. Patients were divided into two groups: those who underwent O-PPPD (n = 113) and those who underwent L-PPPD (n = 104). We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographic and surgical outcomes. We also reviewed all previous studies of more than 100 cases. Results: The L-PPPD group had lesser intraoperative blood loss than the O-PPPD group (548.1 ml vs. 244.7 ml; p < 0.001). Both groups showed similar rates of negative resection margins (99.1{\%} vs. 96.2{\%}; p = 0.196). Overall complication rates did not differ significantly between O-PPPD and L-PPPD (39.8{\%} vs. 35.6{\%}; p = 0.519). The clinically relevant postoperative pancreatic fistula (POPF) rates in the O-PPPD and L-PPPD groups were 18.8{\%} and 13.5{\%}, respectively (p = 0.311). There was no difference in 30- and 90-day mortality rates between the two groups (p = 0.479). Similar results were obtained after PSM analysis. Conclusions: L-PPPD can be a good alternative option for well-selected patients with periampullary lesions requiring PPPD.",
author = "Han, {Sang Hyup} and Kang, {Chang Moo} and Hwang, {Ho Kyoung} and Yoon, {Dong Sup} and Lee, {Woo Jung}",
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The Yonsei experience of 104 laparoscopic pancreaticoduodenectomies : a propensity score-matched analysis with open pancreaticoduodenectomy. / Han, Sang Hyup; Kang, Chang Moo; Hwang, Ho Kyoung; Yoon, Dong Sup; Lee, Woo Jung.

In: Surgical endoscopy, 01.01.2019.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Yonsei experience of 104 laparoscopic pancreaticoduodenectomies

T2 - a propensity score-matched analysis with open pancreaticoduodenectomy

AU - Han, Sang Hyup

AU - Kang, Chang Moo

AU - Hwang, Ho Kyoung

AU - Yoon, Dong Sup

AU - Lee, Woo Jung

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AB - Background: With continued technical advances in surgical instruments and growing expertise, several surgeons have performed laparoscopic pylorus preserving pancreaticoduodenectomy (L-PPPD) safely with good results, and the laparoscopic approach is being performed more frequently. We performed over 100 cases of L-PPPD and compared their outcomes to those of open PPPD (O-PPPD) using the large sample size. The aim of the present study was to evaluate the safety and feasibility of L-PPPD compared with O-PPPD. Methods: From September 2012 to June 2017, PPPD was performed for 217 patients at Yonsei University Severance Hospital by a single surgeon. Patients were divided into two groups: those who underwent O-PPPD (n = 113) and those who underwent L-PPPD (n = 104). We performed a 1:1 propensity score-matched (PSM) analysis and retrospectively analyzed the demographic and surgical outcomes. We also reviewed all previous studies of more than 100 cases. Results: The L-PPPD group had lesser intraoperative blood loss than the O-PPPD group (548.1 ml vs. 244.7 ml; p < 0.001). Both groups showed similar rates of negative resection margins (99.1% vs. 96.2%; p = 0.196). Overall complication rates did not differ significantly between O-PPPD and L-PPPD (39.8% vs. 35.6%; p = 0.519). The clinically relevant postoperative pancreatic fistula (POPF) rates in the O-PPPD and L-PPPD groups were 18.8% and 13.5%, respectively (p = 0.311). There was no difference in 30- and 90-day mortality rates between the two groups (p = 0.479). Similar results were obtained after PSM analysis. Conclusions: L-PPPD can be a good alternative option for well-selected patients with periampullary lesions requiring PPPD.

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