A comparative study of the safety and practicality of single incision plus one versus conventional laparoscopic pancreaticoduodenectomy
YANG Chen-fenglin
LI Yao
CHEN Pin-chu
LI Zhi-xi
DING Jie-ru
WEI Shu-bing
ZHANG Xiao
ZHANG Qi-fan
Abstract：Objective To report the surgical experience of single-incision plus one port laparoscopic pancreaticoduodenectomy(SILPD+1)and to compare its safety and practicality with that of conventional five-port laparoscopic pancreaticoduodenectomy(CLPD).Methods The clinical data of 49 patients who underwent LPD at the Department of Hepatobiliary and Pancreatic Surgery,Nanfang Hospital,Southern Medical University,between February 2023 and April 2024 were retrospectively analyzed,among which 14 patients underwent SILPD+1 and 35 patients underwent CLPD.Results There was no statistically significant differences in the baseline data of the patients in the two groups(P＞0.05)and the rate of conversion to open surgery(x2=0.006,P=0.941).Subsequently,the intraoperative and postoperative data of open cases were no longer included,and further statistical analysis was carried out on 12 cases of SILPD+1 and 32 cases of CLPD.Compared with the CLPD group,patients in the SILPD+1 group had intraoperative blood loss[150.0(100.0,287.5)mL vs.65.0(50.0,137.5)mL,Z=-2.862,P=0.004]and postoperative hospital stay length[15.7(11.9,21.1)d vs.11.2(10.0,14.9)d,Z=-2.109,P=0.035]were less,with lower postoperative pain scores[day 3:4.0(3.3,5.0)points vs.3.0(2.0,3.0)points,Z=-2.715,P=0.007;day 5:3.0(2.0,4.0)d vs.2.0(1.0,3.0)d,Z=-2.150,P=0.032].The quality of recovery scores were higher[day 3:63.0(58.0,68.8)points vs.72.5(68.3,75.8)points,Z=-3.536,P＜0.001;day 5:88.0(81.3,95.0)points vs.98.5(93.0,107.3)points,Z=-3.364,P=0.001],and the satisfaction with incision was higher(x2=4.805,P=0.028),and these differences were statistically significant.There was no statistically significant differences between the two groups in terms of the length of surgery,intraoperative accidental injury of important blood vessels,activities away from the bed,anal exsufflation,complication rate,and surgeon fatigue score(P＞0.05).Conclusion For experienced pancreatic surgeons,SILPD+1 is safe and feasible,with advantages in accelerating perioperative recovery,pain control,and quality of recovery enhancement,without significantly increasing operator fatigue.
Keywords：laparoscopic pancreaticoduodenectomysingle-incision plus one portlaparoscopic surgeryrecent efficacy
Publication Date：2025-02-28
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：8( 187-194 )