Department of Digestive Surgery, Kawasaki Medical School, 577 Matsushima, Kurashiki 701-0192, Japan.
J Hepatobiliary Pancreat Sci. 2013 Apr;20(4):421-8. doi: 10.1007/s00534-012-0578-7.
BACKGROUND/PURPOSE: This study was performed to evaluate the outcomes of laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD) compared with the open method using meta-analysis.
A literature search was performed to identify comparative studies of laparoscopic versus open pancreatectomy. Perioperative outcomes were evaluated by meta-analysis using a fixed effect model and random effects model.
Twenty-four studies of LDP and three studies of LPD matched the selection criteria, including 2,904 patients of DP and 109 patients of PD. Compared with ODP, LDP showed statistically significant differences with respect to less blood loss, lower transfusion rates, lower wound infection rates, lower morbidity rates, and shorter hospital stays. LPD showed significantly longer operative times compared with OPD. There was no significant difference in oncological outcomes between laparoscopic pancreatectomy and the open technique.
This meta-analysis included the largest number of patients and number of articles comparing LDP and ODP, and LDP showed significantly better perioperative outcomes. This meta-analysis suggests that LDP is a reasonable operative method for benign tumors and some ductal carcinomas in the pancreas.
背景/目的：本研究通过荟萃分析评估了腹腔镜胰体尾切除术（LDP）和腹腔镜胰十二指肠切除术（LPD）与开放方法的治疗效果。
对腹腔镜与开放胰切除术的比较研究进行了文献检索。采用固定效应模型和随机效应模型进行荟萃分析，评估围手术期结局。
符合选择标准的 LDP 研究有 24 项，LPD 研究有 3 项，共包括 2904 例 DP 患者和 109 例 PD 患者。与 ODP 相比，LDP 在出血量减少、输血率降低、伤口感染率降低、发病率降低和住院时间缩短方面有显著差异。LPD 与 OPD 相比，手术时间明显延长。腹腔镜胰切除术与开放技术在肿瘤学结果方面无显著差异。
本荟萃分析纳入了比较 LDP 和 ODP 的患者和文章数量最多，LDP 显示出显著更好的围手术期结果。本荟萃分析表明，LDP 是治疗胰腺良性肿瘤和某些导管腺癌的合理手术方法。
