Laparoscopic duodenum-preserving total pancreatic-head resection versus standard pancreaticoduodenectomy for pancreatic-head intraductal papillary mucinous neoplasm.

BACKGROUND

Currently, no literature specifically addresses the curative efficacy of laparoscopic duodenum-preserving total pancreatic head resection (LDPPHRt) in the treatment of pancreatic-head intraductal papillary mucinous neoplasm (IPMN). This study aimed to compare the short-term and long-term outcomes between LDPPHRt and laparoscopic pancreaticoduodenectomy (LPD) for pancreatic-head IPMN.

METHODS

We retrospectively reviewed patients undergoing LDPPHRt or LPD for pancreatic-head IPMN in our institution between September 2014 and October 2020. We collected, analyzed and compared preoperative, intraoperative, and perioperative data, including quality of life as assessed using EORTC QLQ-C30 and QLQ-PAN26 questionnaires.

RESULTS

In total, 50 patients were incorporated into this study, which included 12 LDPPHRt patients and 38 LPD patients. Preoperative data was comparable in the two groups, and neither was there any significant difference in postoperative data. The incidence of exocrine and endocrine insufficiency was similar between the LDPPHRt and LPD groups (50% vs. 28.9%, p = 0.321; 8.3% vs. 7.9%, p = 1.000), but some differences between the two surgical procedures were apparent when evaluating postoperative quality of life. Specifically, patients in the LDPPHRt group reported higher physical functional and body image scores than the LPD group (96.1 ± 6.0 vs. 88.2 ± 13.9, p = 0.008; 65.3 ± 32.9 vs. 43.0 ± 31.4, p = 0.039), and LDPPHRt was also associated with lower digestive symptom scores (5.5 ± 12.9 vs. 28.9 ± 25.9, p = 0.004).

CONCLUSION

Perioperative outcomes for LDPPHRt were comparable to those for LPD, but the quality of life after operation was better in the LDPPHRt group.