Abstract
Laparoscopic distal pancreatectomy (LDP) for benign and low-grade malignant pancreatic diseases has been increasingly utilized. However, the use of LDP for pancreatic ductal adenocarcinoma (PDAC) remains controversial and has not been widely accepted. In this study, the outcomes of LDP versus conventional open distal pancreatectomy (ODP) for left-sided PDAC were examined. A retrospective review of patients who underwent LDP or ODP for left-sided PDAC between January 2010 and January 2019 was conducted. One-to-one propensity score matching (PSM) was used to minimize selection biases by balancing factors including age, sex, ASA grade, tumor size, and combined resection. Demographic data, their pathological and short-term clinical parameters, and long-term oncological outcomes were compared between the LDP and ODP groups. A total of 197 patients with PDAC were enrolled. There were 115 (58.4%) patients in the LDP group and 82 (41.6%) patients in the ODP group. After 1:1 PSM, 66 well-matched patients in each group were evaluated. The LDP group had lesser blood loss (195 vs. 210 mL, p < 0.01), shorter operative time (193.6 vs. 217.5 min; p = 0.02), and shorter hospital stay (12 vs. 15 days, p < 0.01), whereas the overall complication rates were comparable between groups (10.6% vs.16.7%, p = 0.31). There were no significant differences between the LDP and ODP groups regarding 3-year recurrence-free or overall survival rate (p = 0.89 and p = 0.33, respectively). LDP in the treatment of left-sided PDAC is a technically safe, feasible and favorable approach in short-term surgical outcomes. Moreover, patients undergoing LDP than ODP for PDAC had comparable oncological metrics and similar middle-term survival rate.
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Abbreviations
- PDAC:
-
Pancreatic ductal adenocarcinoma
- MIS:
-
Minimally invasive surgery
- DP:
-
Distal pancreatectomy
- LDP:
-
Laparoscopic distal pancreatectomy
- ODP:
-
Open distal pancreatectomy
- PSM:
-
Propensity score matching
- LN:
-
Lymph node
- ITT:
-
Intention-to-treat
- ISGPF:
-
International Study Group on Pancreatic Fistula
- POPF:
-
Postoperative pancreatic fistula
- CR-POPF:
-
Clinically relevant POPF
- RFS:
-
Recurrence-free survival
- OS:
-
Overall survival
- SD:
-
Standard deviation
- DGE:
-
Delayed gastric emptying
- NCDB:
-
National cancer database
- RAMPS:
-
Radical antegrade modular pancreatosplenectomy
- MDCT:
-
Multi-detector computed tomography scan
- BMI:
-
Body mass index
- ASA:
-
American Society of Anesthesiologists
- RBC:
-
Red blood cell
References
Buanes TA (2014) Pancreatic cancer-improved care achievable. World J Gastroenterol 20(30):10405–10418
Chiaravalli M, Reni M, O’Reilly EM (2017) Pancreatic ductal adenocarcinoma: state-of-the-art 2017 and new therapeutic strategies. Cancer Treat Rev 60:32–43
Gawande A (2012) Two hundred years of surgery. N Engl J Med 366(18):1716–1723
Tran Cao HS, Lopez N, Chang DC, Lowy AM, Bouvet M, Baumgartner JM, Talamini MA, Sicklick JK (2014) Improved perioperative outcomes with minimally invasive distal pancreatectomy: results from a population-based analysis. JAMA Surg 149(3):237–243
Anderson B, Karmali S (2014) Laparoscopic resection of pancreatic adenocarcinoma: dream or reality? World J Gastroenterol 20(39):14255–14262
Nakamura M, Wakabayashi G, Miyasaka Y, Tanaka M, Morikawa T, Unno M, Tajima H, Kumamoto Y, Satoi S, Kwon M, Toyama H, Ku Y, Yoshitomi H, Nara S, Shimada K, Yokoyama T, Miyagawa S, Toyama Y, Yanaga K, Fujii T, Kodera Y, Tomiyama Y, Miyata H, Takahara T, Beppu T, Yamaue H, Miyazaki M, Takada T (2015) Multicenter comparative study of laparoscopic and open distal pancreatectomy using propensity score-matching. J Hepatobiliary Pancreat Sci 22(10):731–736
Mehrabi A, Hafezi M, Arvin J, Esmaeilzadeh M, Garoussi C, Emami G, Kossler-Ebs J, Muller-Stich BP, Buchler MW, Hackert T, Diener MK (2015) A systematic review and meta-analysis of laparoscopic versus open distal pancreatectomy for benign and malignant lesions of the pancreas: it’s time to randomize. Surgery 157(1):45–55
de Rooij T, van Hilst J, van Santvoort H, Boerma D, van den Boezem P, Daams F, van Dam R, Dejong C, van Duyn E, Dijkgraaf M, van Eijck C, Festen S, Gerhards M, Groot Koerkamp B, de Hingh I, Kazemier G, Klaase J, de Kleine R, van Laarhoven C, Luyer M, Patijn G, Steenvoorde P, Suker M, Abu Hilal M, Busch O, Besselink M (2019) Minimally invasive versus open distal pancreatectomy (LEOPARD): a multicenter patient-blinded randomized controlled trial. Ann Surg 269(1):2–9
Raoof M, Ituarte PHG, Woo Y, Warner SG, Singh G, Fong Y, Melstrom L (2018) Propensity score-matched comparison of oncological outcomes between laparoscopic and open distal pancreatic resection. Br J Surg 105(5):578–586
de Rooij T, Klompmaker S, Abu Hilal M, Kendrick ML, Busch OR, Besselink MG (2016) Laparoscopic pancreatic surgery for benign and malignant disease. Nat Rev Gastroenterol Hepatol 13(4):227–238
de Rooij T, Besselink MG, Shamali A, Butturini G, Busch OR, Edwin B, Troisi R, Fernandez-Cruz L, Dagher I, Bassi C, Abu Hilal M (2016) Pan-European survey on the implementation of minimally invasive pancreatic surgery with emphasis on cancer. HPB 18(2):170–176
van Hilst J, de Rooij T, Abu Hilal M, Asbun HJ, Barkun J, Boggi U, Busch OR, Conlon KC, Dijkgraaf MG, Han HS, Hansen PD, Kendrick ML, Montagnini AL, Palanivelu C, Rosok BI, Shrikhande SV, Wakabayashi G, Zeh HJ, Vollmer CM, Kooby DA, Besselink MG (2017) Worldwide survey on opinions and use of minimally invasive pancreatic resection. HPB 19(3):190–204
Chen K, Pan Y, Mou YP, Wang GY, Zhang RC, Yan JF, Jin WW, Zhang MZ, Chen QL, Wang XF (2019) Evolution of laparoscopic pancreatic resections for pancreatic and periampullary diseases: perioperative outcomes of 605 patients at a high-volume center. J Laparoendosc Adv Surg Tech Part A 29(9):1085–1092
Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, Allen P, Andersson R, Asbun HJ, Besselink MG, Conlon K, Del Chiaro M, Falconi M, Fernandez-Cruz L, Fernandez-Del Castillo C, Fingerhut A, Friess H, Gouma DJ, Hackert T, Izbicki J, Lillemoe KD, Neoptolemos JP, Olah A, Schulick R, Shrikhande SV, Takada T, Takaori K, Traverso W, Vollmer CR, Wolfgang CL, Yeo CJ, Salvia R, Buchler M (2017) The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after. Surgery 161(3):584–591
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240(2):205–213
Wittekind C, Compton C, Quirke P, Nagtegaal I, Merkel S, Hermanek P, Sobin LH (2009) A uniform residual tumor (R) classification: integration of the R classification and the circumferential margin status. Cancer 115(15):3483–3488
Zhang M, Fang R, Mou Y, Chen R, Xu X, Zhang R, Yan J, Jin W, Ajoodhea H (2015) LDP vs ODP for pancreatic adenocarcinoma: a case matched study from a single-institution. BMC Gastroenterol 15:182. https://doi.org/10.1186/s12876-015-0411-2
Tol JA, Gouma DJ, Bassi C, Dervenis C, Montorsi M, Adham M, Andren-Sandberg A, Asbun HJ, Bockhorn M, Buchler MW, Conlon KC, Fernandez-Cruz L, Fingerhut A, Friess H, Hartwig W, Izbicki JR, Lillemoe KD, Milicevic MN, Neoptolemos JP, Shrikhande SV, Vollmer CM, Yeo CJ, Charnley RM (2014) Definition of a standard lymphadenectomy in surgery for pancreatic ductal adenocarcinoma: a consensus statement by the International Study Group on Pancreatic Surgery (ISGPS). Surgery 156(3):591–600
Oettle H, Neuhaus P, Hochhaus A, Hartmann JT, Gellert K, Ridwelski K, Niedergethmann M, Zulke C, Fahlke J, Arning MB, Sinn M, Hinke A, Riess H (2013) Adjuvant chemotherapy with gemcitabine and long-term outcomes among patients with resected pancreatic cancer: the CONKO-001 randomized trial. JAMA 310(14):1473–1481
Shin SH, Kim SC, Song KB, Hwang DW, Lee JH, Lee D, Lee JW, Jun E, Park KM, Lee YJ (2015) A comparative study of laparoscopic vs. open distal pancreatectomy for left-sided ductal adenocarcinoma: a propensity score-matched analysis. J Am Coll Surg 220(2):177–185. https://doi.org/10.1016/j.jamcollsurg.2014.10.014
Sulpice L, Farges O, Goutte N, Bendersky N, Dokmak S, Sauvanet A, Delpero JR (2015) Laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: time for a randomized controlled trial? Results of an all-inclusive national observational study. Ann Surg 262(5):868–873. https://doi.org/10.1097/sla.0000000000001479(discussion 873-864)
Strasberg SM, Drebin JA, Linehan D (2003) Radical antegrade modular pancreatosplenectomy. Surgery 133(5):521–527
Abe T, Ohuchida K, Miyasaka Y, Ohtsuka T, Oda Y, Nakamura M (2016) Comparison of Surgical outcomes between radical antegrade modular pancreatosplenectomy (RAMPS) and standard retrograde pancreatosplenectomy (SPRS) for left-sided pancreatic cancer. World J Surg 40(9):2267–2275
Zhou Y, Shi B, Wu L, Si X (2017) A systematic review of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas. HPB 19(1):10–15
Park HJ, You DD, Choi DW, Heo JS, Choi SH (2014) Role of radical antegrade modular pancreatosplenectomy for adenocarcinoma of the body and tail of the pancreas. World J Surg 38(1):186–193
Latorre M, Ziparo V, Nigri G, Balducci G, Cavallini M, Ramacciato G (2013) Standard retrograde pancreatosplenectomy versus radical antegrade modular pancreatosplenectomy for body and tail pancreatic adenocarcinoma. Am Surg 79(11):1154–1158
Kim EY, You YK, Kim DG, Hong TH (2016) Initial experience with radical antegrade modular pancreatosplenectomy in a single institution. Ann Surg Treat Res 91(1):29–36
Lee SH, Kang CM, Hwang HK, Choi SH, Lee WJ, Chi HS (2014) Minimally invasive RAMPS in well-selected left-sided pancreatic cancer within Yonsei criteria: long-term (> median 3 years) oncologic outcomes. Surg Endosc 28(10):2848–2855
Asbun HJ, Moekotte AL, Vissers FL, Kunzler F, Cipriani F, Alseidi A, D’Angelica MI, Balduzzi A, Bassi C, Bjornsson B, Boggi U, Callery MP, Del Chiaro M, Coimbra FJ, Conrad C, Cook A, Coppola A, Dervenis C, Dokmak S, Edil BH, Edwin B, Giulianotti PC, Han HS, Hansen PD, van der Heijde N, van Hilst J, Hester CA, Hogg ME, Jarufe N, Jeyarajah DR, Keck T, Kim SC, Khatkov IE, Kokudo N, Kooby DA, Korrel M, de Leon FJ, Lluis N, Lof S, Machado MA, Demartines N, Martinie JB, Merchant NB, Molenaar IQ, Moravek C, Mou YP, Nakamura M, Nealon WH, Palanivelu C, Pessaux P, Pitt HA, Polanco PM, Primrose JN, Rawashdeh A, Sanford DE, Senthilnathan P, Shrikhande SV, Stauffer JA, Takaori K, Talamonti MS, Tang CN, Vollmer CM, Wakabayashi G, Walsh RM, Wang SE, Zinner MJ, Wolfgang CL, Zureikat AH, Zwart MJ, Conlon KC, Kendrick ML, Zeh HJ, Hilal MA, Besselink MG (2020) The Miami international evidence-based guidelines on minimally invasive pancreas resection. Ann Surg 271(1):1–14
Bockhorn M, Uzunoglu FG, Adham M, Imrie C, Milicevic M, Sandberg AA, Asbun HJ, Bassi C, Buchler M, Charnley RM, Conlon K, Cruz LF, Dervenis C, Fingerhutt A, Friess H, Gouma DJ, Hartwig W, Lillemoe KD, Montorsi M, Neoptolemos JP, Shrikhande SV, Takaori K, Traverso W, Vashist YK, Vollmer C, Yeo CJ, Izbicki JR (2014) Borderline resectable pancreatic cancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS). Surgery 155(6):977–988
Pietrasz D, Marthey L, Wagner M, Blanc JF, Laurent C, Turrini O, Raoul JL, Terrebonne E, Hentic O, Trouilloud I, Coriat R, Regenet N, Innominato P, Taieb J, Cunha AS, Bachet JB (2015) Pathologic major response after FOLFIRINOX is prognostic for patients secondary resected for borderline or locally advanced pancreatic adenocarcinoma: an AGEO-FRENCH, prospective, multicentric Cohort. Ann Surg Oncol 22(3):015–4783
Katz MH, Shi Q, Ahmad SA, Herman JM, Marsh Rde W, Collisson E, Schwartz L, Frankel W, Martin R, Conway W, Truty M, Kindler H, Lowy AM, Bekaii-Saab T, Philip P, Talamonti M, Cardin D, LoConte N, Shen P, Hoffman JP, Venook AP (2016) Preoperative modified FOLFIRINOX treatment followed by capecitabine-based chemoradiation for borderline resectable pancreatic cancer: alliance for clinical trials in oncology trial A021101. JAMA Surg 151(8):17
Jegatheeswaran S, Baltatzis M, Jamdar S, Siriwardena AK (2017) Superior mesenteric artery (SMA) resection during pancreatectomy for malignant disease of the pancreas: a systematic review. HPB 19(6):483–490
Mollberg N, Rahbari NN, Koch M, Hartwig W, Hoeger Y, Buchler MW, Weitz J (2011) Arterial resection during pancreatectomy for pancreatic cancer: a systematic review and meta-analysis. Ann Surg 254(6):882–893
Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC 3rd, Kim HJ, Ahmad S, Cho CS, Parikh AA, Chu CK, Hamilton NA, Doyle CJ, Pinchot S, Hayman A, McClaine R, Nakeeb A, Staley CA, McMasters KM, Lillemoe KD (2010) A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg 210(5):779–785. https://doi.org/10.1016/j.jamcollsurg.2009.12.033
Magge D, Gooding W, Choudry H, Steve J, Steel J, Zureikat A, Krasinskas A, Daouadi M, Lee KK, Hughes SJ, Zeh HJ 3rd, Moser AJ (2013) Comparative effectiveness of minimally invasive and open distal pancreatectomy for ductal adenocarcinoma. JAMA Surg 148(6):525–531. https://doi.org/10.1001/jamasurg.2013.1673
Stauffer JA, Coppola A, Villacreses D, Mody K, Johnson E, Li Z, Asbun HJ (2017) Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc 31(5):2233–2241
Stiles ZE, Dickson PV, Deneve JL, Glazer ES, Dong L, Wan JY, Behrman SW (2018) The impact of unplanned conversion to an open procedure during minimally invasive pancreatectomy. J Surg Res 227:168–177
Rehman S, John SK, Lochan R, Jaques BC, Manas DM, Charnley RM, French JJ, White SA (2014) Oncological feasibility of laparoscopic distal pancreatectomy for adenocarcinoma: a single-institution comparative study. World J Surg 38(2):476–483. https://doi.org/10.1007/s00268-013-2268-2
Mendoza AS 3rd, Han HS, Ahn S, Yoon YS, Cho JY, Choi Y (2016) Predictive factors associated with postoperative pancreatic fistula after laparoscopic distal pancreatectomy: a 10-year single-institution experience. Surg Endosc 30(2):649–656
Sahakyan MA, Kazaryan AM, Rawashdeh M, Fuks D, Shmavonyan M, Haugvik SP, Labori KJ, Buanes T, Rosok BI, Ignjatovic D, Abu Hilal M, Gayet B, Kim SC, Edwin B (2016) Laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: results of a multicenter cohort study on 196 patients. Surg Endosc 30(8):3409–3418
Sanchez-Cabus S, Adam JP, Pittau G, Gelli M, Cunha AS (2016) Laparoscopic left pancreatectomy: early results after 115 consecutive patients. Surg Endosc 30(10):4480–4488
de Rooij T, Cipriani F, Rawashdeh M, van Dieren S, Barbaro S, Abuawwad M, van Hilst J, Fontana M, Besselink MG, Abu Hilal M (2017) Single-surgeon learning curve in 111 laparoscopic distal pancreatectomies: does operative time tell the whole story? J Am Coll Surg 224(5):826–832
Dokmak S, Fteriche FS, Aussilhou B, Levy P, Ruszniewski P, Cros J, Vullierme MP, Khoy Ear L, Belghiti J, Sauvanet A (2017) The largest European single-center experience: 300 laparoscopic pancreatic resections. J Am Coll Surg 225(2):226–234
Diener MK, Seiler CM, Rossion I, Kleeff J, Glanemann M, Butturini G, Tomazic A, Bruns CJ, Busch OR, Farkas S, Belyaev O, Neoptolemos JP, Halloran C, Keck T, Niedergethmann M, Gellert K, Witzigmann H, Kollmar O, Langer P, Steger U, Neudecker J, Berrevoet F, Ganzera S, Heiss MM, Luntz SP, Bruckner T, Kieser M, Buchler MW (2011) Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet 377(9776):1514–1522
Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr (2013) A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg 216(1):1–14. https://doi.org/10.1016/j.jamcollsurg.2012.09.002
Panni RZ, Guerra J, Hawkins WG, Hall BL, Asbun HJ, Sanford DE (2019) National pancreatic fistula rates after minimally invasive pancreaticoduodenectomy: a NSQIP analysis. J Am Coll Surg 21(19):30151–30156
di Sebastiano P, Grottola T, di Mola FF (2016) Borderline resectable pancreatic cancer and the role of neoadjuvant chemoradiotherapy. Updates Surg 68(3):235–239
Valls C, Andia E, Sanchez A, Fabregat J, Pozuelo O, Quintero JC, Serrano T, Garcia-Borobia F, Jorba R (2002) Dual-phase helical CT of pancreatic adenocarcinoma: assessment of resectability before surgery. Am J Roentgenol 178(4):821–826
Walters DM, Lapar DJ, de Lange EE, Sarti M, Stokes JB, Adams RB, Bauer TW (2011) Pancreas-protocol imaging at a high-volume center leads to improved preoperative staging of pancreatic ductal adenocarcinoma. Ann Surg Oncol 18(10):2764–2771
Allen VB, Gurusamy KS, Takwoingi Y, Kalia A, Davidson BR (2016) Diagnostic accuracy of laparoscopy following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer. Cochrane Database Syst Rev 6(7):CD009323
Gaujoux S, Allen PJ (2010) Role of staging laparoscopy in peri-pancreatic and hepatobiliary malignancy. World J Gastrointest Surg 2(9):283–290
Delpero JR, Bachellier P, Regenet N, Le Treut YP, Paye F, Carrere N, Sauvanet A, Autret A, Turrini O, Monges-Ranchin G, Boher JM (2014) Pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: a French multicentre prospective evaluation of resection margins in 150 evaluable specimens. HPB 16(1):20–33
Esposito I, Kleeff J, Bergmann F, Reiser C, Herpel E, Friess H, Schirmacher P, Buchler MW (2008) Most pancreatic cancer resections are R1 resections. Ann Surg Oncol 15(6):1651–1660
Delpero JR, Jeune F, Bachellier P, Regenet N, Le Treut YP, Paye F, Carrere N, Sauvanet A, Adham M, Autret A, Poizat F, Turrini O, Boher JM (2017) Prognostic value of resection margin involvement after pancreaticoduodenectomy for Ductal adenocarcinoma: updates from a french prospective multicenter study. Ann Surg 266(5):787–796
van Hilst J, Korrel M, de Rooij T, Lof S, Busch OR, Groot Koerkamp B, Kooby DA, van Dieren S, Abu Hilal M, Besselink MG (2019) Oncologic outcomes of minimally invasive versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis. Eur J Surg Oncol 45(5):719–727
van Hilst J, de Rooij T, Klompmaker S, Rawashdeh M, Aleotti F, Al-Sarireh B, Alseidi A, Ateeb Z, Balzano G, Berrevoet F, Bjornsson B, Boggi U, Busch OR, Butturini G, Casadei R, Del Chiaro M, Chikhladze S, Cipriani F, van Dam R, Damoli I, van Dieren S, Dokmak S, Edwin B, van Eijck C, Fabre JM, Falconi M, Farges O, Fernandez-Cruz L, Forgione A, Frigerio I, Fuks D, Gavazzi F, Gayet B, Giardino A, Groot Koerkamp B, Hackert T, Hassenpflug M, Kabir I, Keck T, Khatkov I, Kusar M, Lombardo C, Marchegiani G, Marshall R, Menon KV, Montorsi M, Orville M, de Pastena M, Pietrabissa A, Poves I, Primrose J, Pugliese R, Ricci C, Roberts K, Rosok B, Sahakyan MA, Sanchez-Cabus S, Sandstrom P, Scovel L, Solaini L, Soonawalla Z, Souche FR, Sutcliffe RP, Tiberio GA, Tomazic A, Troisi R, Wellner U, White S, Wittel UA, Zerbi A, Bassi C, Besselink MG, Abu Hilal M (2019) Minimally invasive versus open distal pancreatectomy for Ductal adenocarcinoma (DIPLOMA): a Pan-European Propensity Score matched study. Ann Surg 269(1):10–17
Chen K, Pan Y, Zhang B, Maher H, Cai XJ (2018) Laparoscopic versus open pancreatectomy for pancreatic ductal adenocarcinoma: a systematic review and meta-analysis. Int J Surg 53:243–256
Sharpe SM, Talamonti MS, Wang E, Bentrem DJ, Roggin KK, Prinz RA, Marsh RD, Stocker SJ, Winchester DJ, Baker MS (2015) The laparoscopic approach to distal pancreatectomy for ductal adenocarcinoma results in shorter lengths of stay without compromising oncologic outcomes. Am J Surg 209(3):557–563
Kantor O, Bryan DS, Talamonti MS, Lutfi W, Sharpe S, Winchester DJ, Prinz RA, Baker MS (2017) Laparoscopic distal pancreatectomy for cancer provides oncologic outcomes and overall survival identical to open distal pancreatectomy. J Gastrointest Surg 21(10):1620–1625
Croome KP, Farnell MB, Que FG, Reid-Lombardo KM, Truty MJ, Nagorney DM, Kendrick ML (2014) Total laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic advantages over open approaches? Annals of surgery 260(4):633–638. https://doi.org/10.1097/sla.0000000000000937(discussion 638-640)
Nussbaum DP, Adam MA, Youngwirth LM, Ganapathi AM, Roman SA, Tyler DS, Sosa JA, Blazer DG 3rd (2016) Minimally invasive pancreaticoduodenectomy does not improve use or time to initiation of adjuvant chemotherapy for patients with pancreatic adenocarcinoma. Ann Surg Oncol 23(3):1026–1033
Kim HW, Lee JC, Lee J, Kim JW, Kim J, Hwang JH (2017) Early versus delayed initiation of adjuvant treatment for pancreatic cancer. PLoS One 12(3):e0173960
Mirkin KA, Greenleaf EK, Hollenbeak CS, Wong J (2016) Time to the initiation of adjuvant chemotherapy does not impact survival in patients with resected pancreatic cancer. Cancer 122(19):2979–2987
Perinel J, Adham M (2016) ERAS and pancreatic surgery: a review. Updates Surg 68(3):253–255
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This research was supported by Scientific and Technological Project of Zhejiang Province (Grant Nos. 2017C33094, LGF19H150007, LY20H160020, LGF20H030009).
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Chen, K., Tong, Q., Yan, Jf. et al. Laparoscopic versus open distal pancreatectomy for pancreatic ductal adenocarcinoma: a single-center propensity score matching study. Updates Surg 72, 387–397 (2020). https://doi.org/10.1007/s13304-020-00742-5
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DOI: https://doi.org/10.1007/s13304-020-00742-5