|
Back to 2014 Annual Meeting Abstracts
Pancreaticoduodenectomy With Major Vascular Resection: a Comparisson of Laparoscopic Versus Open Approaches
Kristopher Croome*, Michael B. Farnell, Mark J. Truty, Florencia G. Que, Kaye M. Reid Lombardo, David M. Nagorney, Michael L. Kendrick
Mayo Clinic, Rochester, MN
Background: Major vascular resection (MVR) with open pancreaticoduodenectomy is well-established with peri-operative and oncological outcomes that are similar to patients undergoing pancreaticoduodenectomy without venous involvement. This study compares outcomes of total laparoscopic versus open pancreaticoduodenectomy with MVR.
Methods: Single institution, retrospective review of all patients undergoing laparoscopic or open pancreaticoduodenectomy with MVR between the dates of July 2007 and July 2013.
Results: A total of 89 patients (31 laparoscopic, 58 open) underwent pancreaticoduodenectomy with MVR. Mean operative blood loss was significantly less in the laparoscopic (842cc) compared to the open group (1452cc) (p<0.001) as was median operative stay, 6 (4-118) days versus 9 (6-73) days respectively (P=0.006). There was no significant difference in the total number of complications (lap 35%, open 48%) (p=0.24) or severe complications (≥ IIIB) (lap 6.4%, open 3.4%) (p=0.51) in the 2 groups. In-hospital mortality or 90 day mortality was not different between the laparoscopic and open groups, 3.2% and 3.4% respectively (p=0.96). Patency rates of the reconstructed vessels on post-operative imaging were not different between the laparoscopic (93%) and open groups (91%) (p=0.76). In patients with a diagnosis of adenocarcinoma there was no difference in overall survival between the 2 groups (p=0.22).
Conclusion: Total laparoscopic pancreaticoduodenectomy with major vascular resection is not only feasible and safe but can achieve results that are similar to open approaches with regard to morbidity, mortality and oncologic outcome.
Back to 2014 Annual Meeting Abstracts
|
