Manivasagam Sri Saran, Chandra J Nemi
General Surgery, Maulana Azad Medical College, New Delhi, IND.
General Surgery, Vardhman Mahavir Medical College & Safdarjung Hospital, New Delhi, IND.
Cureus. 2024 Feb 1;16(2):e53387. doi: 10.7759/cureus.53387. eCollection 2024 Feb.
Laparoscopic pancreaticoduodenectomy (LPD) has gained popularity as an alternative to open pancreaticoduodenectomy (OPD), but comparative outcomes remain debated. The objective is to perform a systematic review and meta-analysis comparing LPD and OPD on operative time, oncologic outcomes, bleeding, morbidity, and mortality. The inclusion criteria were comparative studies on LPD vs. OPD. Outcomes were pooled using random-effects meta-analysis. A total of 27 studies were included, and LPD had a substantially longer operative duration compared to the OPD procedure, with a mean increase of 56 minutes, but blood loss was reduced by an average of 123 mL in patients who underwent LPD. Morbidity, mortality, margin status, and lymph node yields were similar between LPD and OPD. This study found comparable oncologic outcomes between LPD and OPD. LPD appears safe but requires longer operative time. High-quality randomized trials are still needed.
腹腔镜胰十二指肠切除术（LPD）作为开放性胰十二指肠切除术（OPD）的替代方法已越来越受欢迎，但比较结果仍存在争议。目的是进行一项系统评价和荟萃分析，比较LPD和OPD在手术时间、肿瘤学结果、出血、发病率和死亡率方面的差异。纳入标准为LPD与OPD的比较研究。使用随机效应荟萃分析汇总结果。共纳入27项研究，与OPD手术相比，LPD的手术持续时间显著更长，平均增加56分钟，但接受LPD的患者失血量平均减少123 mL。LPD和OPD之间的发病率、死亡率、切缘状态和淋巴结收获量相似。本研究发现LPD和OPD之间的肿瘤学结果相当。LPD似乎是安全的，但需要更长的手术时间。仍需要高质量的随机试验。
