Lin Zhengwei, Feng Fei, Ye Yingpeng, Yang Yong, Zhu Hongda, Zhou Xinhua, Li Hong, Lu Caide, Fang Jiongze
Department of Hepato-Pancreato-Billiary Surgery, The Affiliated Lihuili Hospital of Ningbo University, Ningbo, China.
Gland Surg. 2024 May 30;13(5):607-618. doi: 10.21037/gs-23-538. Epub 2024 May 27.
Open surgery is gradually replaced by minimally invasive surgery, but few studies have reported the feasibility of laparoscopic pancreaticoduodenectomy (LPD) combined with vascular resection and reconstruction. The present study compared the efficacy of LPD with open pancreaticoduodenectomy (OPD) combined with portal vein/superior mesenteric vein (PV/SMV) resection and reconstruction for pancreatic cancer.
The clinical data of patients who underwent PD combined with PV/SMV resection and reconstruction from March 2016 to August 2022 at our institution were retrospectively analyzed. The perioperative outcomes and survival outcomes were compared after propensity score matching (PSM).
The original cohort included 64 patients. Sixteen pairs of patients were obtained by 1:1 PSM. The intraoperative blood loss was greater in the OPD group than in the LPD group (550 . 200 mL, P=0.04), and the PV clamp time was longer in the LPD group than in the OPD group (29.4 . 18.8 min, P<0.001). There was no significant difference in the incidence of postoperative complications. The median overall survival and progression-free survival were comparable between the two groups (P>0.05).
LPD combined with PV/SMV resection and reconstruction is safe and feasible in selected patients and results in similar perioperative outcomes and prognosis as open surgery.
开放手术正逐渐被微创手术取代，但很少有研究报道腹腔镜胰十二指肠切除术（LPD）联合血管切除与重建的可行性。本研究比较了LPD与开放胰十二指肠切除术（OPD）联合门静脉/肠系膜上静脉（PV/SMV）切除与重建治疗胰腺癌的疗效。
回顾性分析2016年3月至2022年8月在我院接受PD联合PV/SMV切除与重建的患者临床资料。倾向评分匹配（PSM）后比较围手术期结局和生存结局。
原始队列包括64例患者。通过1:1 PSM获得16对患者。OPD组术中失血量多于LPD组（550±200 mL，P = 0.04），LPD组PV阻断时间长于OPD组（29.4±18.8分钟，P<0.001）。术后并发症发生率无显著差异。两组中位总生存期和无进展生存期相当（P>0.05）。
LPD联合PV/SMV切除与重建在选定患者中是安全可行的，围手术期结局和预后与开放手术相似。
