Related Experiment Video
Updated: May 26, 2025
Laparoscopic Radical Left Pancreatectomy for Pancreatic Cancer: Surgical Strategy and Technique Video
Published on: June 6, 2020
Effect of Laparoscopic Versus Open Distal Pancreatectomy on Recurrence-free Survival in Patients With Left-sided
Chen Liu1,2,3,4, He Cheng1,2,3,4, Min Wang5
1Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, Shanghai, China.
Objective:
To evaluate the oncological superiority of laparoscopic distal pancreatectomy (LDP) versus open distal pancreatectomy (OPD) in left-sided pancreatic cancer.
Background:
The oncological efficacy of LDP in left-sided pancreatic cancer remains controversial.
Methods:
We performed a multicenter, open-label, randomized controlled trial of LDP versus OPD in left-sided pancreatic cancer patients. Candidates were recruited from 6 centers in China, and randomly assigned to receive either LDP or ODP. The primary outcome was recurrence-free survival, and the secondary outcomes were overall survival, R0 resection rate, and retrieved lymph node numbers.
Results:
Of the 481 eligible pancreatic cancer patients between January 9, 2019 and December 8, 2021, 306 candidates were initially enrolled and randomly assigned at 1:1 to receive either LDP or ODP. The last follow-up was performed on December 15, 2023, and 130 patients in the LDP group and 129 patients in the ODP group were included for per-protocol analysis. Median recurrence-free survival was 15.5 (12.5-18.5) months in the LDP group compared with 15 (9.5-20.5) months in the ODP group ( P = 0.471). The R0 resection rate in 2 groups was 88.5% versus 89.1%, respectively. Median retrieved lymph node numbers in 2 groups were similar [13.5 (10-20) vs 12 (7-17), P = 0.165]. Complications with a Clavien-Dindo score ≥ 3 occurred in 10 of 130 patients in the LDP group, and 11 of 129 patients in the ODP group.
Conclusions:
Although LDP did not provide significant oncological benefits for left-sided pancreatic cancer, it was safe, applicable, and appropriate.
