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Perioperative outcomes of laparoscopic pancreaticoduodenectomy for benign and borderline malignant periampullary disease compared to open pancreaticoduodenectomy

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Abstract

Purpose

The objective of this study was to compare perioperative outcomes between laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) for benign and borderline malignant periampullary diseases.

Methods

Of 107 pancreaticoduodenectomy cases for non-malignant diseases from March 1993 to July 2017, 76 patients underwent OPD and 31 patients received LPD. To adjust for baseline differences and selection bias, operative outcomes and complications were compared after propensity score matching (PSM).

Results

After 1:1 PSM, well-matched 31 patients in each group were evaluated. As a result, significant differences were observed between two groups in some aspects: mean operative time (LPD 426.8 ± 98.58 vs. OPD 355.03 ± 100.0 min, p = 0.031), estimated blood loss (LPD 477.42 ± 374.80 vs. OPD 800.00 ± 531.35 ml, p = 0.008), and postoperative hospital stay (LPD 14.74 ± 5.40 vs. OPD 23.81 ± 11.63 days, p < 0.001). The average visual analogue scores for pain observed from patients in LPD group on postoperative day (POD) 1 (4.23 ± 1.83 vs. 5.55 ± 2.50, p = 0.021) and POD 3 (3.32 ± 1.66 vs. 5.26 ± 2.76, p = 0.002) were significantly less than those from patients in OPD group, as well. There were no significant differences between groups about major complications including the rate of postoperative pancreatic fistula.

Conclusions

LPD is a safe procedure and provides less postoperative pain and the shortening length of hospitalization. LPD may serve the feasible alternative approach for benign and borderline malignant periampullary disease.

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Authors and Affiliations

  1. Department of Hepatobiliary and Pancreas Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Chul Seung Lee, Young Kyoung You & Tae Ho Hong

  2. Department of Trauma and Surgical Critical Care, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea

    Eun Young Kim

Authors
  1. Chul Seung Lee
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  2. Eun Young Kim
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  3. Young Kyoung You
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Contributions

Chul Seung Lee and Tae Ho Hong performed this study and drafted the manuscript. Eun Young Kim and Young Kyoung You helped to collect the data and calculate the statistical analysis. Tae Ho Hong conceived and designed the study and revised the manuscript. Young Kyoung You supervised the whole work. All authors read and approved the manuscript.

Corresponding author

Correspondence to Tae Ho Hong.

Ethics declarations

The study was approved by St. Mary’s Hospital Research Ethics Board (IRB KC17RESI0669). Informed consent was obtained from each participant.

Conflict of interest

The authors declare that they have no conflict of interest.

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Lee, C.S., Kim, E.Y., You, Y.K. et al. Perioperative outcomes of laparoscopic pancreaticoduodenectomy for benign and borderline malignant periampullary disease compared to open pancreaticoduodenectomy. Langenbecks Arch Surg 403, 591–597 (2018). https://doi.org/10.1007/s00423-018-1691-0

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  • DOI: https://doi.org/10.1007/s00423-018-1691-0

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