Pancreatoduodenectomy Clinical Trial
Official title:
Outcome After Laparoscopic Versus Open Pancreaticoduodenectomy: a Single Surgeon Experience
Aim of the study :
To determine the morbimortality of Laparoscopic pancreaticoduodenectomy (LPD) compared to the
gold standard Open pancreaticoduodenectomy approach (OPD).
Methods :
This is a monocentric retrospective study based on a prospectively maintained clinical
database. The study included 28 consecutive patients operated, between January 2016 and March
2019, of Laparoscopic pancreaticoduodenectomy (LPD) that we compared to 62 patients operated
with the classical open approach by the same surgeon before the first laparoscopic resection
at our institution.
The progress achieved over the last 20 years and the growing experience of visceral surgeons
in minimally invasive surgery allow us today to embark on increasingly complex surgeries.
Laparoscopic surgery has even become the gold standard approach for many interventions,
whether for bariatric functional surgery, reflux surgery, pelvic static disorder surgery, but
also for tumor surgery such as colorectal cancer, esophageal or tail of the pancreas.
However, there are still interventions which, due to their technical difficulty, do not find
unanimous consensus among the international scientific community for a possible minimally
invasive approach.
The close contact of the pancreatic gland with the splenomesaraic trunk making laparoscopic
dissection difficult with risk of uncontrollable bleeding.
It seems, however, that the finesse of the dissection and coagulation instruments and the
precision of today's optics make it possible to approach the head of the pancreas in
completely satisfactory conditions.
Several centers around the world have developed the LPD technique with encouraging results in
terms of perioperative mortality without showing any advantage over laparotomy.
At the Montpellier University Hospital we started performing Laparoscopic
pancreaticoduodenectomy (LPD) at the beginning of 2016.
The aim of this study is to assess, on the one hand, the morbimortality and the quality of
surgery linked to the development of this relatively new technique in a reference center for
pancreatic surgery and on the other hand to assess a possible learning curve effect within
our experience.
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