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Minimally invasive surgical approach versus open procedure for pancreaticoduodenectomy: A systematic review and

Shunda Wang1, Ning Shi, Lei You

  • 1Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.

Medicine
|February 3, 2018
PubMed
Abstract

Insights

Minimally invasive pancreaticoduodenectomy (MIPD) is safe and feasible compared to open pancreaticoduodenectomy (OPD). MIPD offers reduced complications and shorter hospital stays, despite longer operative times, making it a valuable surgical option.

Area of Science:

  • Surgical Oncology
  • Gastrointestinal Surgery

Background:

  • Minimally invasive pancreaticoduodenectomy (MIPD) is a complex procedure with debated safety and feasibility compared to open pancreaticoduodenectomy (OPD).
  • Evaluating the comparative outcomes of MIPD and OPD is crucial for surgical decision-making.

Purpose of the Study:

  • To systematically review and meta-analyze the existing literature comparing MIPD and OPD.
  • To assess the feasibility and safety of MIPD versus OPD in terms of postoperative complications, intraoperative outcomes, oncologic data, and recovery.

Main Methods:

  • Systematic literature review identifying studies comparing MIPD and OPD.
  • Meta-analysis of postoperative complications, intraoperative outcomes, oncologic data, and postoperative recovery.

Main Results:

  • MIPD demonstrated significantly lower rates of postoperative hemorrhage and wound infection.
  • MIPD was associated with less blood loss, lower transfusion rates, and shorter hospital stays.
  • While operative time was longer for MIPD, R0 resection rates and lymph node yield were higher, with no significant differences in pancreatic fistula, delayed gastric emptying, bile leakage, or mortality.

Conclusions:

  • Minimally invasive pancreaticoduodenectomy (MIPD) is a safe, feasible, and beneficial surgical approach.
  • Further large-scale randomized controlled trials are recommended to solidify the role of MIPD.

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