Total laparoscopic pancreaticoduodenectomy <i>versus</i> open pancreaticoduodenectomy: a meta-analysis based on non-RCT studies_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

JIANG Kangyi , GAO Fengwei ,  LEI Zehua , FU Jinqiang , DU Bo , WANG Zhixu , XIE Qingyun , ZHOU Quanyu , XUE Qian , ZHAO Xin

Department of Hepatobiliary Pancreatic and Splenic Surgery, The People's Hospital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding?author：

LEI Zehua, Email: leitsehua@126.com

Keywords：

pancreaticoduodenectomy; laparoscopic operation; open operation; meta-analysis

DOI：

10.7507/1007-9424.201812067

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective This meta-analysis aimed to systematically evaluate the feasibility and the safety of total laparoscopic pancreatoduodenectomy (TLPD) by comparing it with open pancreatoduodenectomy (OPD).Methods We searched the relative domestic and international data bases systematically, such as the Cochrane Library, Medline Database, SCI, CBM, VIP-data, CNKI-data, and WanFang Data. We selected case control studies or cohort studies, and used the Review Manager 5.3 to perform statistical analysis.Results In total, thirteen single-center retrospective case-control studies were included, totally 808 patients involved, and there were 401 cases in the TLPD group and 407 cases in the OPD group. There were no significant difference in terms of the cumulative morbidity, incidence of the Clavien Ⅲ-Ⅴ complication, pancreatic fistula, B/C pancreatic fistula, biliary fistula, postoperative hemorrhage, pulmonary infection, and gastric emptying delay, as well as the ratio of secondary operation, mortality of perioperative period, the ration of R0 resection, and the number of lymph nodes dissected between the 2 groups (P>0.05). Although the operative time was significant longer, TLPD had significant superiority in terms of the amount of bleeding and blood transfusion during operation, the hospital stays after operation, the bowel function recovery time, the time to restart eating, and the time to reactivate (P<0.05).Conclusion In terms of the relative complications and the parameters of oncology such as the ration of R0 resection, the number of lymph nodes dissected, both of the procedures are safe and feasible, while TLPD is more favorable to control operative bleeding and accelerate rehabilitation.

Citation： JIANG Kangyi, GAO Fengwei, LEI Zehua, FU Jinqiang, DU Bo, WANG Zhixu, XIE Qingyun, ZHOU Quanyu, XUE Qian, ZHAO Xin. Total laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy: a meta-analysis based on non-RCT studies. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2019, 26(4): 448-457. doi: 10.7507/1007-9424.201812067 Copy

1.	彭兵, 王明俊. 腹腔鏡胰十二指腸切除術的歷史與現狀. 中國普外基礎與臨床雜志, 2016, 23(4): 385-387.
2.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
3.	洪德飛. 腹腔鏡胰腺切除術發展機遇與挑戰. 浙江醫學, 2017, 39(22): 1943-1947.
4.	Sally G, Julian PH, Philip A, et al. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration, 2008.
5.	Zureikat AH, Breaux JA, Steel JL, et al. Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg, 2011, 15(7): 1151-1157.
6.	衛洪波, 魏波, 鄭宗珩, 等. 腹腔鏡與開放胰十二指腸切除術療效的對比觀察. 中華胃腸外科雜志, 2014, 17(5): 465-468.
7.	Hakeem AR, Verbeke CS, Cairns A, et al. A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol. Hepatobiliary Pancreat Dis Int, 2014, 13(4): 435-441.
8.	Tan CL, Zhang H, Peng B, et al. Outcome and costs of laparoscopic pancreaticoduodenectomy during the initial learning curve vs laparotomy. World J Gastroenterol, 2015, 21(17): 5311-5319.
9.	魏秋亞, 劉永永, 閆衛峰, 等. 全腹腔鏡與開腹胰十二指腸切除術的臨床配對研究. 中華肝膽外科雜志, 2016, 22(5): 332-335.
10.	Khaled YS, Fatania K, Barrie J, et al. Matched case-control comparative study of laparoscopic versus open pancreaticoduodenectomy for malignant lesions. Surg Laparosc Endosc Percutan Tech, 2018, 28(1): 47-51.
11.	Conrad C, Basso V, Passot G, et al. Comparable long-term oncologic outcomes of laparoscopic versus open pancreaticoduodenectomy for adenocarcinoma: a propensity score weighting analysis. Surg Endosc, 2017, 31(10): 3970-3978.
12.	王文斌, 閆長青, 呂海濤, 等. 腹腔鏡與開腹胰十二指腸切除術療效分析. 中華肝膽外科雜志, 2017, 23(2): 110-113.
13.	吳萬龍, 王明俊, 蔡云強, 等. 腹腔鏡與開腹胰十二指腸切除術近期療效的對比研究. 外科理論與實踐, 2017, 22(2): 123-128.
14.	符真, 張劍權, 陳漢宗. 腹腔鏡與開放手術方式在胰十二指腸切除術中的應用比較. 廣東醫學, 2017, 38(15): 2367-2370.
15.	李方寬, 王小明, 孫衛東, 等. 腹腔鏡和開腹胰十二指腸切除術的近期臨床療效對比. 皖南醫學院學報, 2017, 36(6): 535-538.
16.	王哲元, 張亞武, 權柯. 腹腔鏡與傳統手術治療膽總管下段癌的臨床療效對比. 醫學研究雜志, 2017, 46(12): 143-148.
17.	Chen XM, Sun DL, Zhang Y. Laparoscopic versus open pancreaticoduodenectomy combined with uncinated process approach: a comparative study evaluating perioperative outcomes (retrospective cohort study). Int J Surg, 2018, 51: 170-173.
18.	Cai Y, Gao P, Li Y, et al. Laparoscopic pancreaticoduodenectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach. Surg Endosc, 2018, 32(10): 4209-4215.
19.	金巍巍, 徐曉武, 牟一平, 等. 腹腔鏡胰十二指腸切除術單中心 233 例臨床經驗總結. 中華外科雜志, 2017, 55(5): 354-358.
20.	劉學青, 邢中強, 秦建章, 等. 腹腔鏡胰十二指腸切除術單中心 300 例臨床分析. 中國實用外科雜志, 2018, 38(3): 306-311.
21.	姜翀弋, 王巍. 腹腔鏡胰十二指腸切除術的血管解剖與手術徑路分析. 腹腔鏡外科雜志, 2018, 23(5): 329-332.
22.	Gagner M, Pomp A. Laparoscopic pancreatic resection: is it worthwhile? J Gastrointest Surg, 1997, 1(1): 20-25.
23.	Boggi U, Amorese G, Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc, 2015, 29(1): 9-23.
24.	Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg, 2015, 220(4): 530-536.
25.	張亞武, 王哲元, 權柯, 等. 腹腔鏡與開腹胰十二指腸切除術治療胰頭癌的療效對比分析. 中國普外基礎與臨床雜志, 2015, 25(9): 1078-1082.
26.	Croome KP, Farnell MB, Que FG, et al. Total laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic advantages over open approaches? Ann Surg, 2014, 260(4): 633-638.
27.	嚴力鋒, 王釗, 洪德飛, 等. 腹腔鏡胰十二指腸切除術進展. 中華肝膽外科雜志, 2008, 14(11): 828-830.
28.	苗毅, 高文濤. 腹腔鏡胰十二指腸切除的規范化相關問題. 中華普外科手術學雜志: 電子版, 2015, 9(4): 240-242.
29.	李非, 彭承宏, 戴夢華. 胰頭癌根治性切除: 開腹與腹腔鏡手術的合理選擇. 中國實用外科雜志, 2017, 37(7): 766-767.

1. 彭兵, 王明俊. 腹腔鏡胰十二指腸切除術的歷史與現狀. 中國普外基礎與臨床雜志, 2016, 23(4): 385-387.
2. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc, 1994, 8(5): 408-410.
3. 洪德飛. 腹腔鏡胰腺切除術發展機遇與挑戰. 浙江醫學, 2017, 39(22): 1943-1947.
4. Sally G, Julian PH, Philip A, et al. Cochrane handbook for systematic reviews of interventions. The Cochrane Collaboration, 2008.
5. Zureikat AH, Breaux JA, Steel JL, et al. Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg, 2011, 15(7): 1151-1157.
6. 衛洪波, 魏波, 鄭宗珩, 等. 腹腔鏡與開放胰十二指腸切除術療效的對比觀察. 中華胃腸外科雜志, 2014, 17(5): 465-468.
7. Hakeem AR, Verbeke CS, Cairns A, et al. A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol. Hepatobiliary Pancreat Dis Int, 2014, 13(4): 435-441.
8. Tan CL, Zhang H, Peng B, et al. Outcome and costs of laparoscopic pancreaticoduodenectomy during the initial learning curve vs laparotomy. World J Gastroenterol, 2015, 21(17): 5311-5319.
9. 魏秋亞, 劉永永, 閆衛峰, 等. 全腹腔鏡與開腹胰十二指腸切除術的臨床配對研究. 中華肝膽外科雜志, 2016, 22(5): 332-335.
10. Khaled YS, Fatania K, Barrie J, et al. Matched case-control comparative study of laparoscopic versus open pancreaticoduodenectomy for malignant lesions. Surg Laparosc Endosc Percutan Tech, 2018, 28(1): 47-51.
11. Conrad C, Basso V, Passot G, et al. Comparable long-term oncologic outcomes of laparoscopic versus open pancreaticoduodenectomy for adenocarcinoma: a propensity score weighting analysis. Surg Endosc, 2017, 31(10): 3970-3978.
12. 王文斌, 閆長青, 呂海濤, 等. 腹腔鏡與開腹胰十二指腸切除術療效分析. 中華肝膽外科雜志, 2017, 23(2): 110-113.
13. 吳萬龍, 王明俊, 蔡云強, 等. 腹腔鏡與開腹胰十二指腸切除術近期療效的對比研究. 外科理論與實踐, 2017, 22(2): 123-128.
14. 符真, 張劍權, 陳漢宗. 腹腔鏡與開放手術方式在胰十二指腸切除術中的應用比較. 廣東醫學, 2017, 38(15): 2367-2370.
15. 李方寬, 王小明, 孫衛東, 等. 腹腔鏡和開腹胰十二指腸切除術的近期臨床療效對比. 皖南醫學院學報, 2017, 36(6): 535-538.
16. 王哲元, 張亞武, 權柯. 腹腔鏡與傳統手術治療膽總管下段癌的臨床療效對比. 醫學研究雜志, 2017, 46(12): 143-148.
17. Chen XM, Sun DL, Zhang Y. Laparoscopic versus open pancreaticoduodenectomy combined with uncinated process approach: a comparative study evaluating perioperative outcomes (retrospective cohort study). Int J Surg, 2018, 51: 170-173.
18. Cai Y, Gao P, Li Y, et al. Laparoscopic pancreaticoduodenectomy with major venous resection and reconstruction: anterior superior mesenteric artery first approach. Surg Endosc, 2018, 32(10): 4209-4215.
19. 金巍巍, 徐曉武, 牟一平, 等. 腹腔鏡胰十二指腸切除術單中心 233 例臨床經驗總結. 中華外科雜志, 2017, 55(5): 354-358.
20. 劉學青, 邢中強, 秦建章, 等. 腹腔鏡胰十二指腸切除術單中心 300 例臨床分析. 中國實用外科雜志, 2018, 38(3): 306-311.
21. 姜翀弋, 王巍. 腹腔鏡胰十二指腸切除術的血管解剖與手術徑路分析. 腹腔鏡外科雜志, 2018, 23(5): 329-332.
22. Gagner M, Pomp A. Laparoscopic pancreatic resection: is it worthwhile? J Gastrointest Surg, 1997, 1(1): 20-25.
23. Boggi U, Amorese G, Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc, 2015, 29(1): 9-23.
24. Cameron JL, He J. Two thousand consecutive pancreaticoduodenectomies. J Am Coll Surg, 2015, 220(4): 530-536.
25. 張亞武, 王哲元, 權柯, 等. 腹腔鏡與開腹胰十二指腸切除術治療胰頭癌的療效對比分析. 中國普外基礎與臨床雜志, 2015, 25(9): 1078-1082.
26. Croome KP, Farnell MB, Que FG, et al. Total laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic advantages over open approaches? Ann Surg, 2014, 260(4): 633-638.
27. 嚴力鋒, 王釗, 洪德飛, 等. 腹腔鏡胰十二指腸切除術進展. 中華肝膽外科雜志, 2008, 14(11): 828-830.
28. 苗毅, 高文濤. 腹腔鏡胰十二指腸切除的規范化相關問題. 中華普外科手術學雜志: 電子版, 2015, 9(4): 240-242.
29. 李非, 彭承宏, 戴夢華. 胰頭癌根治性切除: 開腹與腹腔鏡手術的合理選擇. 中國實用外科雜志, 2017, 37(7): 766-767.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Total laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy: a meta-analysis based on non-RCT studies

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content