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Published on: June 17, 2018
Minimally invasive surgery versus open surgery for total pancreatectomy: a bibliometric review and meta-analysis
Kongyuan Wei1, Luying Cheng2, Qingyong Zheng2
1Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany; Faculty of Hepatopancreatobiliary Surgery, The First Medical Center of Chinese People's Liberation Army (PLA) General Hospital, Beijing, China.
Background:
Minimally invasive total pancreatectomy (MITP) is considered safe and feasible with limited evidence on this procedure. The aim of this study was to systematically analyze the current literature on MITP compared to open TP (OTP).
Method:
Randomized controlled trials and prospective non-randomized comparative studies were sought systematically in MEDLINE, Web of Science and CENTRAL from their inception until December 2021. Outcome measures included operative time, length of hospital stay (LOH), spleen-preservation rate, estimated blood loss (EBL), need for transfusion, venous resection rate, delayed gastric emptying (DGE), biliary leakage, postpancreatectomy hemorrhage (PPH), reoperation rate, overall 30-day morbidity (Clavien-Dindo > IIIa), 90-day mortality, 90-day readmission, examined lymph nodes (ELN). Pooled results are presented as odds ratios (OR) or mean difference (MD) with 95% confidence interval (CI).
Results:
7 observational studies with a total of 4212 patients were included. MITP had a decreased EBL and transfusion rate, lower 30-day morbidity and 90-day mortality with a longer LOH compared to OTP. There were no significant differences regarding operative time, spleen preservation rate, DGE, biliary leakage, venous resection rate, PPH, reoperation, 90-day readmission and ELN.
Discussion:
Based on the available studies, MITP is safe and feasible compared to OTP in highly experienced hands from high-volume centers. Further high-quality studies are needed to verify the conclusion.
Insights
Minimally invasive total pancreatectomy (MITP) is safe and feasible, showing lower blood loss and mortality than open total pancreatectomy (OTP). However, MITP involves a longer hospital stay, with outcomes comparable in other aspects.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Minimally Invasive Surgery
Background:
- Minimally invasive total pancreatectomy (MITP) is a developing surgical approach.
- Limited evidence exists comparing MITP to traditional open total pancreatectomy (OTP).
Conclusions:
- Minimally invasive total pancreatectomy is a safe and feasible option when performed by experienced surgeons in high-volume centers.
- Further high-quality research is necessary to validate these findings and establish definitive conclusions.
