A comparative analysis of safety and short-term efficacy between open and laparoscopic pancreaticoduodenectomy...

To evaluate the safety profiles of open pancreaticoduodenectomy (OPD) and laparoscopic pancreaticoduodenectomy (LPD), and to analyze the respective advantages and disadvantages of various internal and external drainage techniques.

All 260 patients successfully underwent laparoscopic or open PD. They were divided into laparoscopy and laparotomy groups by surgical approach, and into internal and external drainage groups by drainage method. Four subgroups were then formed: minimally invasive surgical internal drainage (MIS-ID) and minimally invasive surgical external drainage (MIS-ED), open surgical internal surgical drainage (OS-ID) and open surgical external drainage (OS-ED). Perioperative outcomes were compared across all groups and subgroups.

No significant differences were observed between the laparoscopy and laparotomy groups in patient characteristics (P > 0.05). Compared to laparotomy group, the laparoscopy group had significantly higher ALB levels on postoperative days 1, 3, and 5, and higher Hb levels on postoperative days 3 and 5 (P < 0.05), with no significant differences in intraoperative or other postoperative clinical indicators (P > 0.05). No significant differences were found between the MIS-ID and MIS-ED subgroups in perioperative clinical and laboratory parameters (P > 0.05). Compared to the OS-ID subgroup, the OS-ED subgroup showed significantly higher ALB levels on postoperative days 3 and 5, and shorter duration of abdominal drainage (P < 0.05), with no significant differences in intraoperative or other postoperative clinical indicators (P > 0.05).

LPD can be performed safely and effectively without increasing postoperative complications compared to OPD. During LPD, the choice between internal and external drainage does not significantly influence outcomes following PD. Overall, LPD represents a safe and effective surgical approach, demonstrating significant potential for widespread adoption and clinical application.