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Surgical Loupe at 4.0× Magnification in Pancreaticoduodenectomy-Does It Affect the Surgical Outcomes? A Propensity
Mohamed El Shobary1, Ayman El Nakeeb1, Ahmad Sultan1
11 Mansoura University, Mansoura, Egypt.
Background:
There is paucity of data about the impact of using magnification on rate of pancreatic leak after pancreaticoduodenectomy (PD). The aim of this study was to show the impact of using magnifying surgical loupes 4.0× EF (electro-focus) on technical performance and surgical outcomes of PD.
Patients And Method:
This is a propensity score-matched study. Thirty patients underwent PD using surgical loupes at 4.0× magnification (Group A), and 60 patients underwent PD using the conventional method (Group B). The primary outcome was postoperative pancreatic fistula. Secondary outcomes included operative time, intraoperative blood loss, postoperative complications, mortality, and hospital stay.
Results:
The total operative time was significantly longer in the loupe group ( P = .0001). The operative time for pancreatic reconstruction was significantly longer in the loupe group ( P = .0001). There were no significant differences between both groups regarding hospital stay, time to oral intake, total amount of drainage, and time of nasogastric tube removal. Univariate and multivariate analyses demonstrated 3 independent factors of development of postoperative pancreatic fistula: pancreatic duct <3 mm, body mass index >25, and soft pancreas.
Conclusion:
Surgical loupes 4.0× added no advantage in surgical outcomes of PD with regard to improvement of postoperative complications rate or mortality rate.
Insights
Magnifying surgical loupes did not improve outcomes for pancreaticoduodenectomy (PD). This study found no significant difference in pancreatic leak rates or other complications when using 4.0× magnification during PD.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Limited data exists on magnification's effect on pancreatic leak post-pancreaticoduodenectomy (PD).
- Investigating the impact of 4.0× electro-focus (EF) surgical loupes on PD technical performance and outcomes.
Purpose of the Study:
- To evaluate the effect of 4.0× magnification surgical loupes on postoperative pancreatic fistula rates after PD.
- To assess the influence of loupes on operative time, blood loss, complications, mortality, and hospital stay.
Main Methods:
- Propensity score-matched study comparing 30 patients using 4.0× loupes (Group A) with 60 patients using conventional methods (Group B).
- Primary outcome: postoperative pancreatic fistula. Secondary outcomes: operative time, blood loss, complications, mortality, hospital stay.
Main Results:
- Operative time, particularly for pancreatic reconstruction, was significantly longer in the loupe group (P=.0001).
- No significant differences observed in hospital stay, oral intake resumption, drainage, or nasogastric tube removal time.
- Independent risk factors for pancreatic fistula identified: pancreatic duct diameter <3 mm, BMI >25, and soft pancreas texture.
Conclusions:
- 4.0× surgical loupes offered no discernible advantage in improving surgical outcomes for PD.
- Magnification did not reduce postoperative complications or mortality rates in this PD cohort.
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