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- Title
Totally laparoscopic or robot-assisted pancreaticoduodenectomy versus open surgery for periampullary neoplasms: separate systematic reviews and meta-analyses.
- Authors
Shin, Sang; Kim, Ye-Jee; Song, Ki; Kim, Seong-Ryong; Hwang, Dae; Lee, Jae; Park, Kwang-Min; Lee, Young-Joo; Jun, Eunsung; Kim, Song; Shin, Sang Hyun; Song, Ki Byung; Hwang, Dae Wook; Lee, Jae Hoon; Kim, Song Cheol
- Abstract
<bold>Objective: </bold>To compare perioperative and oncologic outcomes of pure (totally) laparoscopic pancreaticoduodenectomy (TLPD) or robot-assisted pancreaticoduodenectomy (RAPD) with those of conventional open pancreaticoduodenectomy (OPD).<bold>Methods: </bold>A systematic literature search was performed using PubMed, EMBASE, and Cochrane library databases. Studies comparing TLPD with OPD and RAPD with OPD were included; only original studies reporting more than 10 cases for each technique were included. Studies were combined using a random-effects model to report heterogeneous data, or a fixed-effects model was applied.<bold>Results: </bold>TLPD involved longer operative time (weighted mean difference [WMD]: 116.85 min; 95% confidence interval [CI] 54.53-179.17) and significantly shorter postoperative hospital stay (WMD: -3.68 days; 95% CI -4.65 to -2.71). Overall morbidity and postoperative pancreatic fistula were not significantly different between TLPD and OPD. RAPD was associated with a longer operative time, less intraoperative blood loss, and shorter hospital stay. Oncologic outcomes were not significantly different among the procedure types.<bold>Conclusions: </bold>Compared to OPD, TLPD and RAPD were feasible and oncologically safe procedures. However, there are no prospective studies, and the majority of the studies on TLPD and RAPD have remained in the early training phase. In addition to randomized controlled trials or prospective studies, new data from the late training phase of learning experiences should also be analyzed.
- Subjects
PANCREATICODUODENECTOMY; AMPULLA of Vater; LAPAROSCOPIC surgery; SURGICAL robots; PANCREATIC fistula; BLOOD loss estimation; TUMORS; COMPARATIVE studies; DUODENUM; LAPAROSCOPY; RESEARCH methodology; MEDICAL cooperation; PANCREATIC tumors; RESEARCH; BILE duct tumors; EVALUATION research; TREATMENT effectiveness; DUCTAL carcinoma; STATISTICAL models
- Publication
Surgical Endoscopy & Other Interventional Techniques, 2017, Vol 31, Issue 9, p3459
- ISSN
1866-6817
- Publication type
journal article
- DOI
10.1007/s00464-016-5395-7