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KMID : 1143920210250030358
Annals of Hepato-Biliary-Pancreatic Surgery
2021 Volume.25 No. 3 p.358 ~ p.365
Comparison of perioperative outcomes in pancreatic head cancer patients following either a laparoscopic or open pancreaticoduodenectomy with a superior mesenteric artery first approach
Park Min-Young

Lee Woo-Hyung
Kwon Jae-Woo
Song Ki-Byung
Hwang Dae-Wook
Lee Jae-Hoon
Kim Song-Cheol
Abstract
Backgrounds/Aims: A superior mesenteric artery first approach (SFA) technique can improve the complete resection rate. It can be used to determine whether an operation can be performed by invading the superior mesenteric artery before performing a pancreatic transection in patients with pancreatic ductal adenocarcinoma (PDAC). The aim of this study was to compare perioperative outcomes between laparoscopic and open SFA for PDAC.

Methods: Between January 2017 and August 2019, consecutive patients who underwent laparoscopic and open pancreaticoduodenectomy (PD) for PDAC using SFA procedures were included and compared between laparoscopic and open procedures.

Results: Fourteen and 83 patients underwent laparoscopic and open surgeries, respectively. In perioperative outcomes, there were no significant differences in the amount of intraoperative blood loss or transfusion rate between the two groups. In the laparoscopic group, the operation time was longer with less patients showing wound infection. R0 resection rate and the number of retrieved lymph nodes showed no significant difference. The average time to adjuvant chemotherapy was longer in the open group. There was no significant difference in the mean survival time or the recurrence free period.

Conclusions: Patients who underwent laparoscopic PD using SFA showed perioperative outcomes comparable compared to those of patients who underwent open procedures performed by experienced surgeons.
KEYWORD
Carcinoma, pancreatic ductal, Pancreaticoduodenectomy, Mesenteric artery, superior, Laparoscopes
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