LAPAROSCOPIC VERSUS OPEN PANCREATICODUODENECTOMY FOR PANCREATIC TUMORS: A COMPARISON OF OUTCOME PROFILES
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Keywords
Pancreaticoduodenectomy, Laparoscopy, Pancreatic Adenocarcinoma, Outcomes.
Abstract
Background: Pancreaticoduodenectomy (PD) is a complex surgical procedure primarily used to treat pancreatic and periampullary tumors, associated with high morbidity and mortality. The benefit and safety of laparoscopic pancreatoduodenectomy (LPD) for the treatment of pancreatic or periampullary tumors remain controversial.
Objective: To evaluate and compare the postoperative outcomes in patients undergoing laparoscopic versus open pancreaticoduodenectomy in a developing country.
Methods: This concurrent cohort study, conducted at Khyber Teaching Hospital, Peshawar, from September 2022 to September, 2024, enrolled 59 patients with resectable periampullary cancers. Data were collected using a specific proforma and analyzed with SPSS version 26. The independent t-test compared continuous variables between laparoscopic and open pancreaticoduodenectomy groups, the Chi-square test and logistic regression evaluated the impact of the procedures on outcomes.
Results: LPD was associated with a significantly shorter length of hospital stay (7.80days) compared to open PD (16.50days; p<0.001). Additionally, LPD resulted in significantly less blood loss (202.50ml) compared to OPD (415.00ml, p<0.001). The operative time for LPD was notably longer (357.00minutes) compared to OPD (230.00minutes; p<0.001). The rates of postoperative complications, including delayed gastric emptying, pancreatic fistula, and surgical site infections, were comparable between LPD and OPD, with no significant differences in overall morbidity and mortality (p=0.506).
Conclusion: LPD is a viable and effective procedure, offering benefits such as a shorter length of stay and reduced blood loss compared to OPD. However, the clinical advantages of LPD over OPD appear to be marginal, even with significant procedural expertise.
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Dr. Mohammad Zarin
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.
Dr. Zia Ullah
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.
Dr. Muhammad Imran Khan
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.
Dr. Shahzeb Khan
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.
Dr. Izaz Ullah
Department of Surgery, Combined Military Hospital, Peshawar, Pakistan.
Dr. Muhammad Ahmad
Khyber Medical College, Peshawar, Pakistan.
Dr. Samra Fakhar
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.
Dr. Tayyab Afareen
Department of Surgery, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan.