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Postoperative Pancreatic Fistula: Is Minimally Invasive Surgery Better than Open? A Systematic Review and

Niccolo Petrucciani1, Anna Crovetto1, Francesca DE Felice2

  • 1Department of Medical and Surgical Sciences and Translational Medicine, St Andrea University Hospital, Sapienza University, Rome, Italy.

Anticancer Research
|July 5, 2022
PubMed
Abstract

Insights

Minimally invasive pancreaticoduodenectomy (MIPD) and open pancreaticoduodenectomy (OPD) show similar rates of postoperative pancreatic fistula (POPF). This meta-analysis found no significant difference in POPF, complications, or mortality between MIPD and OPD.

Area of Science:

  • Surgical Oncology
  • Gastroenterology
  • Comparative Effectiveness Research

Background:

  • Minimally invasive pancreaticoduodenectomy (MIPD) is increasingly adopted.
  • The incidence of postoperative pancreatic fistula (POPF) is a key concern following pancreaticoduodenectomy (PD).

Purpose of the Study:

  • To compare the incidence of POPF between minimally invasive and open pancreaticoduodenectomy procedures.
  • Evaluate differences in major complications and mortality between surgical approaches.

Main Methods:

  • A meta-analysis adhering to PRISMA guidelines.
  • Literature search focused on studies comparing open pancreaticoduodenectomy (OPD) and MIPD regarding POPF incidence.

Main Results:

  • Twenty-one studies with 4,448 patients (2,456 OPD, 1,992 MIPD) were analyzed.
  • No statistically significant differences in POPF rates (14.3% vs. 12.9%, p=0.25) were observed.
  • Major complications and mortality rates were comparable between OPD and MIPD groups.

Conclusions:

  • MIPD and OPD demonstrate comparable outcomes regarding POPF.
  • Both surgical approaches exhibit similar rates of postoperative complications and mortality.
Keywords:
Pancreaticoduodenectomyduodenopancreatectomypancreatic cancerpancreatic fistulapancreatic neoplasmsreview

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