Comparing laparoscopic and open pancreaticoduodenectomy in patients with pancreatic head cancer: oncologic outcomes and inflammatory scores
Comparing laparoscopic and open pancreaticoduodenectomy in patients with pancreatic head cancer: oncologic outcomes and inflammatory scores
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DOI：
10.1002/jhbp.697
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发表时间：
2019-12-12
影响因子：
3
通讯作者：
Kang, Chang Moo
中科院分区：
文献类型：
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作者：
Choi, Munseok;Hwang, Ho Kyoung;Kang, Chang Moo
背景腹腔镜胰头切除术（LPD）治疗胰头癌的技术和肿瘤学安全性仍存在争议。我们评估了LPD的肿瘤学益处，并比较了LPD和开放性胰腺癌切除术（OPD）之间的炎症评分。方法选择2014年1月至2019年3月收治的61例未合并其他器官切除的标准PD患者。在这些患者中，27例接受了LPD，34例接受了OPD（登记于2019年7月16日，登记号为2019-1411-001）。结果LPD组的估计出血量（EBL）低于OPD组（P = 0.003）。两组手术时间相似，术后瘘、胃排空延迟等并发症发生率相似。LPD和OPD的总生存期无差异（44.62 vs. 45.29个月，P = 0.223）。然而，LPD组的无病生存期（DFS）显著改善（34.19 vs. 23.27个月，P = 0.027）。术后炎症评分和分化白色血细胞计数的变化无统计学显著差异。结论LPD治疗胰头癌安全可行，可减少EBL，改善无瘤生存率。
Background Both the technical and oncological safety of laparoscopic pancreaticoduodenectomy (LPD) remain controversial in treating pancreatic head cancer. We evaluated the oncologic benefit of LPD and compared the inflammatory score between LPD and open pancreaticoduodenectomy (OPD). Methods From January 2014 to March 2019, 61 patients with standard PD not combined with other organ resection were finally enrolled in this study. Among these patients, 27 underwent LPD and 34 underwent OPD (registered on 16 July 2019, and registration number is 2019-1411-001). Results The estimated blood loss (EBL) for the LPD group was less than that of the OPD group (P = 0.003). The operation time was similar, as was the incidence of complications such as postoperative fistula, delayed gastric emptying. Overall survival was not different between LPD and OPD (44.62 vs. 45.29 months, P = 0.223). However, a significant improvement in disease-free survival (DFS) was seen in the LPD group (34.19 vs. 23.27 months, P = 0.027). No statistically significant differences were found in terms of the postoperative change in inflammatory scores and differentiated white blood cell counts. Conclusions LPD is not only safe and feasible in pancreatic head cancer patients but is associated with a reduced amount of EBL, favorable DFS.