Abstract:
Application and Evaluation of Laparoscopy-assisted Pancreaticoduodenectomy in DuodenalPapillary CarcinomaFan ZHOU, Mingwen HUANG, Zhi XU, Zhiqiang LUO, Shubing ZOU, Jianghua SHAO, KaiWANGCorrespondence to: Mingwen HUANG, E-mail: jxnchmw@126.comDepartment of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, ChinaAbstract Objective: To explore the feasibility and efficacy of laparoscopically assisted pancreaticoduodenctomy ( LAPD ) inpatients with duodenal papillary carcinoma. Methods: Clinical data of 17 patients with duodenal papillary carcinoma who underwentpancreaticoduodenectomy were reviewed. Of the 17 cases, laparoscopy-assisted pancreaticoduodenctomy ( LAPD ) was conducted in 7cases and open pancreaticoduodenectomy ( OPD ) was performed in 10 cases. Various indices including the surgical method, intraopera-tive blood loss, duration of surgery, intraoperative difficulties, and postoperative recovery were analyzed. Results: There were no signif-icant differences in general clinicopathologic data, including the age and sex distribution, body mass index, tumor size, or pathologystaging between the groups. The mean duration of surgery in the LAPD group ( 334.29±32.07 min ) was similar to that in the OPDgroup ( 287.00±52.72 min, P = 0.053 ), without statistical differences between the two groups. There was a positive correlation betweenthe surgical duration and body mass index in the LAPD group ( r = 0.809, P = 0.028 ). However, there were statistically significant dif-ferences between the two groups in mean blood loss ( 112.86±62.64 ) mL vs. ( 266.50 60.28 ) mL , the number of cases requiring in-traoperative transfusion ( 1 vs. 4 ), incision length ( 7.87±1.79 ) cm vs. ( 15.20±1.62 ) cm , average time to first ambulation ( 4.14±0.69 ) d vs. ( 5.10±0.57 ) d, time to borborygmus recovery ( 3.57±0.79 ) d vs. ( 4.40±0.70 ) d , and length of postoperative hospitalstay ( 17.57±3.69 ) d vs. ( 20.80±2.25 ) d ( P < 0.05 ). All data were better in the LAPD group than in the OPD group. No significantdifferences in the postoperative complications were found between the two groups. Conclusion: Laparoscopy-assisted pancreaticoduo-denectomy for selected cases with duodenal papillary carcinoma is feasible and safe, and has a definite superiority over OPD. Caseswith a favorable tumor location and low body mass index were ideally suited to be treated with this surgical method.