Dergiler / Şişli Etfal Hastanesi Tıp Bülteni / 2022 / Cilt: 56 - Sayı: 2

Minimally Invasive Pancreaticoduodenectomy: Similar Morbidity and No Mortality in the Learning Period

Sayfa
238–243
Yayın Tarihi
2022-10-17
DOI
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⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

Considering the operation time, it was found that the operation time was longer in patients who received minimally invasive surgical treatment and this was statistically significant (p

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Amaç & Hipotez:Objectives: Pancreaticoduodenectomy (PD) is one of the most challenging operations in gastrointestinal system due to the difficulty of dissection areas and the need for complex reconstruction.
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Temel Bulgular & Veri:The aim of this study is to compare the morbidity, post-operative pancreatic fistula (POPF), and mortality rates of the cases we have from the learning period for minimally invasive PD and our previous open PD cases with similar fistula risk scores (FRSs).
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Sonuç & Katkı:Considering the operation time, it was found that the operation time was longer in patients who received minimally invasive surgical treatment and this was statistically significant (p
🔬Tür:Araştırma Makalesi
📍Kapsam:Genişletilmiş Akademik Örneklem
⚙️Değişkenler:Alan Parametreleri

Abstract

Objectives: Pancreaticoduodenectomy (PD) is one of the most challenging operations in gastrointestinal system due to the difficulty of dissection areas and the need for complex reconstruction. The aim of this study is to compare the morbidity, post-operative pancreatic fistula (POPF), and mortality rates of the cases we have from the learning period for minimally invasive PD and our previous open PD cases with similar fistula risk scores (FRSs). Methods: Patients with similar age, ASA score, pre-operative drainage, and FRS were included in the study. A total of 71 patients, 48 of whom were operated with open surgery and 23 with minimally invasive methods, were included in the study. Results: When the statistical analysis performed, no statistically significant difference was found between open surgery and minimally invasive surgery groups in terms of age, gender, ASA score, pre-operative drainage, pancreatic texture, and treatment of pancreatic leakage (p=0.27, p=0.09, p=0.4, p=0.39, p=0.76, and p=0.36, respectively). There was a statistically significant difference between two groups in terms of clinically relevant pancreatic anastomotic leakage (Grade-B and Grade-C fistula) (p=0.11). The rate of Grade-BL and B leakage was higher in the minimally invasive surgery group, while Grade-C fistula was not observed in any patient (p=0.002). However, there was no statistically significant difference between the two groups in terms of the management of pancreatic leakage and related morbidity (p=0.36). There was no significant difference between the two groups in terms of tumor size, number of lymph nodes removed, FRS, amount of intraoperative bleeding, and diameter of Wirsung and common bile duct (p=0.15, p=0.20, p=0.145, p=0.80, and p=0.073, respectively). Considering the operation time, it was found that the operation time was longer in patients who received minimally invasive surgical treatment and this was statistically significant (p

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Bu Makaleye Atıf Yap

ÖTER, V., BOSTANCI, E. B., ÇOLAKOĞLU, M. K., ÖZGÜN, Y. M., PİŞKİN, E., AYDIN, O. (2022). Minimally Invasive Pancreaticoduodenectomy: Similar Morbidity and No Mortality in the Learning Period. Şişli Etfal Hastanesi Tıp Bülteni, Cilt: 56 - Sayı: 2, 238–243. https://ajindex.com/articles/594594

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Kaynakça (11)

  1. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc 1994;8:408–10
  2. Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience. Arch Surg 2010;145:19–23
  3. Palanivelu C, Senthilnathan P, Sabnis SC, Babu NS, Srivatsan Gurumurthy S, Anand Vijai N, et al. Randomized clinical trial of laparoscopic versus open pancreatoduodenectomy for periampullary tumours. Br J Surg 2017;104:1443–50. 4. van Hilst J, de Rooij T, Bosscha K, Brinkman DJ, van Dieren S, Dijkgraaf MG, et al; Dutch Pancreatic Cancer Group. Laparoscopic versus open pancreatoduodenectomy for pancreatic or periampullary tumours (LEOPARD-2): a multicentre, patient-blinded, randomised controlled phase 2/3 trial. Lancet Gastroenterol Hepatol 2019;4:199–207
  4. Clavien PA, Barkun J, de Oliveira ML, Vauthey JN, Dindo D, Schulick RD, et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009;250:187–96
  5. Bassi C, Marchegiani G, Dervenis C, Sarr M, Abu Hilal M, Adham M, et al; International Study Group on Pancreatic Surgery (ISGPS). The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 Years After. Surgery 2017;161:584–91
  6. Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM Jr. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg 2013;216:1–14
  7. Mungroop TH, van Rijssen LB, van Klaveren D, Smits FJ, van Woerden V, Linnemann RJ, et al; Dutch Pancreatic Cancer Group. Alternative fistula risk score for pancreatoduodenectomy (aFRS): design and ınternational external validation. Ann Surg 2019;269:937–43
  8. Mungroop TH, Klompmaker S, Wellner UF, Steyerberg EW, Coratti A, D'Hondt M, et al; European Consortium on Minimally Invasive Pancreatic Surgery (E-MIPS). Updated alternative fistula risk score (ua-FRS) to include minimally ınvasive pancreatoduodenectomy: pan-European validation. Ann Surg 2021;273:334–40
  9. Lu C, Jin W, Mou YP, Zhou J, Xu X, Xia T, et al. Analysis of learning curve for laparoscopic pancreaticoduodenectomy. J Vis Surg 2016;2:145
  10. Speicher PJ, Nussbaum DP, White RR, Zani S, Mosca PJ, Blazer DG 3rd, et al. Defining the learning curve for team-based laparoscopic pancreaticoduodenectomy. Ann Surg Oncol 2014;21:4014–9
  11. Wang M, Meng L, Cai Y, Li Y, Wang X, Zhang Z, et al. Learning curve for la