Kantor Olga, Talamonti Mark S, Sharpe Susan, Lutfi Waseem, Winchester David J, Roggin Kevin K, Bentrem David J, Prinz Richard A, Baker Marshall S
Department of Surgery, University of Chicago, Chicago, IL, United States.
Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
Am J Surg. 2017 Mar;213(3):512-515. doi: 10.1016/j.amjsurg.2016.10.030. Epub 2016 Dec 28.
The long-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) relative to open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma has not been well studied.
The National Cancer Data Base was used to compare patients undergoing LPD and OPD for stage I-II pancreatic adenocarcinoma between 2010 and 2013.
828 (10%) patients underwent LPD and 7385 (90%) OPD. There were no differences in tumor or demographic characteristics between groups. On multivariable analysis adjusted for hospital volume, LPD was associated with a lower rate of readmission (p < 0.01) and trends toward shorter initial length of stay (p = 0.14) and time to adjuvant chemotherapy (p = 0.11). There were no differences between patients undergoing LPD and those undergoing OP in rates of margin negative resection, number of lymph nodes examined, perioperative mortality and median overall survival (20.7 vs 20.9 months, p = 0.68).
For patients with localized pancreatic adenocarcinoma, LPD provides short-term oncologic and long-term overall survival outcomes identical to OPD and is associated with decreased rates of readmission and a trend towards accelerated recovery.
腹腔镜胰十二指肠切除术（LPD）相对于开放性胰十二指肠切除术（OPD）治疗胰腺腺癌的长期疗效尚未得到充分研究。
利用国家癌症数据库比较2010年至2013年间接受LPD和OPD治疗I-II期胰腺腺癌的患者。
828例（10%）患者接受了LPD，7385例（90%）接受了OPD。两组之间的肿瘤或人口统计学特征没有差异。在根据医院规模进行调整的多变量分析中，LPD与再入院率较低相关（p < 0.01），且初始住院时间较短（p = 0.14）和辅助化疗时间较短（p = 0.11）的趋势相关。接受LPD的患者与接受OP的患者在切缘阴性切除率、检查的淋巴结数量、围手术期死亡率和中位总生存期方面没有差异（20.7个月对20.9个月，p = 0.68）。
对于局限性胰腺腺癌患者，LPD提供的短期肿瘤学和长期总生存结果与OPD相同，且与再入院率降低和恢复加速趋势相关。
