Study on the feasibility and safety of laparoscopic total duodenocecal head preservation
LI Chang-xu
XU Meng
XIAO Li
WANG Bing
DUAN Xi-bin
ZHU Feng
Abstract：Objective To investigate the clinical efficacy of laparoscopic duodenal total pancreatic head resection(LDPTPHR).Methods A retrospective analysis was conducted on the perioperative and postoperative follow-up data of 70 patients who underwent LDPTPHR and 70 patients who underwent laparoscopic pancreaticoduodenectomy(LPD)at the Department of Hepatobiliary and Pancreatic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology between April 2020 and June 2024.Results There was a statistically significant difference in the maximum tumor diameter between the LDPTPHR group and the LPD group[2.4(2.0,3.3)cm vs.3.0(2.3,3.7)cm,P=0.001].The LDPTPHR group had shorter operation time[(205.6±30.4)min vs.(246.7±36.8)min,P＜0.001],shorter gastric tube retention time[25.2(23.0,29.9)h vs.44.7(40.3,49.0)h,P＜0.001],earlier postoperative drinking time[34.1(29.9,36.3)h vs.53.0(48.7,57.1)h,P＜0.001],earlier postoperative eating time[41.6(39.5,44.8)h vs.61.5(56.3,65.7)h,P＜0.001],lower proportion of Clavien-Dindo complication grades(Z=2.597,P=0.009),earlier removal of pancreaticojejunostomy abdominal drainage tube[10.0(9.0,12.0)d vs.12.0(11.0,14.0)d,P＜0.001],and shorter postoperative hospital stay[(11.4±3.1)d vs.(16.4±2.9)d,P＜0.001]compared with the LPD group.At the last follow-up,the ECOG PS score of the LDPTPHR group was better than that of the LPD group(x2=5.414,P=0.020),with a statistically significant difference.There was no statistically significant difference in the pancreaticojejunostomy time,intraoperative blood loss,incidence of pancreatic fistula,incidence of biliary fistula,incidence of chylous fistula,incidence of delayed gastric emptying,incidence of abdominal infection,postoperative bleeding rate,incidence of common bile duct stones,incidence of biliary stricture,30 d readmission rate,and reoperation rate between the two groups(P＞0.05).Conclusion In the treatment of low-grade malignant,borderline and benign diseases of the pancreatic head,LDPTPHR is safe and feasible compared with LPD.
Keywords：laparoscopeduodenum-preserving total pancreatic head resectionpancreaticoduodenectomysurgical complications
Publication Date：2025-05-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 570-575 )