Comparison of Perioperative Outcomes Between Laparoscopic and Open Approach for Pancreatoduodenectomy: The PADULAP Randomized Controlled Trial
- PMID: 30138162
- DOI: 10.1097/SLA.0000000000002893
Comparison of Perioperative Outcomes Between Laparoscopic and Open Approach for Pancreatoduodenectomy: The PADULAP Randomized Controlled Trial
Abstract (VSports注册入口)
Objective: To compare perioperative outcomes of pancreatoduodenectomy (PD) performed through the laparoscopic route or by open surgery. VSports手机版.
Summary background data: Laparoscopic PD is being progressively performed in selected patients V体育安卓版. .
Methods: An open-label single-center RCT was conducted between February 2013 and September 2017. The primary endpoint was the length of hospital stay (LOS). Secondary endpoints were operative time, transfusion requirements, specific pancreatic complications (pancreatic or biliary fistula, pancreatic hemorrhage, and delayed gastric emptying), Clavien-Dindo grade ≥ 3 complications, comprehensive complication index (CCI) score, poor quality outcome (PQO), and the quality of pathologic resection. Analyses were performed on an intention to treat basis V体育ios版. .
Results: Of 86 patients assessed for PD, 66 were randomized (34 laparoscopic approach, 32 open surgery). Conversion to an open procedure was needed in 8 (23. 5%) patients. Laparoscopic versus open PD was associated with a significantly shorter LOS (median 13. 5 vs. 17 d; P = 0. 024) and longer median operative time (486 vs. 365 min; P = 0. 0001). The laparoscopic approach was associated with significantly better outcomes regarding Clavien-Dindo grade ≥ 3 complications (5 vs. 11 patients; P = 0. 04), CCI score (20. 6 vs VSports最新版本. 29. 6; P = 0. 038), and PQO (10 vs. 14 patients; P = 0. 041). No significant differences in transfusion requirements, pancreas-specific complications, the number of lymph nodes retrieved, and resection margins between the two approaches were found. .
Conclusions: Laparoscopic PD versus open surgery is associated with a shorter LOS and a more favorable postoperative course while maintaining oncological standards of a curative-intent surgical resection V体育平台登录. .
Trial registry: ISRCTN93168938. VSports注册入口.
Comment in
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Response to Comment on "Pancreatoduodenectomy: Still an Open Race for a Gold Standard?".Ann Surg. 2019 Dec;270(6):e90-e91. doi: 10.1097/SLA.0000000000003344. Ann Surg. 2019. PMID: 31033493 No abstract available.
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V体育安卓版 - Response to Comment on "Comparison of Perioperative Outcomes Between the Laparoscopic and Open Approach for Pancreaticoduodenectomy. Can We Compare the Results of the Laparoscopic Approach With Bad Results of the Open Approach?".Ann Surg. 2019 Dec;270(6):e92. doi: 10.1097/SLA.0000000000003343. Ann Surg. 2019. PMID: 31045872 No abstract available.
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Comment on "Pancreatoduodenectomy: Still an Open Race for a Gold Standard".Ann Surg. 2019 Dec;270(6):e90. doi: 10.1097/SLA.0000000000003352. Ann Surg. 2019. PMID: 31058696 No abstract available.
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Comment on "Comparison of Perioperative Outcomes Between the Laparoscopic and Open Approach for Pancreaticoduodenectomy: Can We Compare the Results of the Laparoscopic Approach With Bad Results of the Open Approach?".Ann Surg. 2019 Dec;270(6):e91-e92. doi: 10.1097/SLA.0000000000003351. Ann Surg. 2019. PMID: 31726625 No abstract available.
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