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- W3143403978 abstract "Introduction: In our first experience Laparoscopic pancreaticoduodenectmoy (LPD) was associated with higher morbidity. Since we restrict LPD to patients at lower risk of pancreatic fistula (PF) and we ameliorate our surgical technique. We analyzed our recent results. Methods and patients: Between 2011-2018, 130 pure LPD were performed, divided in 3 consecutive periods: period 1 (n=43), period 2 (n=43=) and period 3 (n=44) and were compared. Results: In the third period, more females (48%, 46%, 59%, p=0.12), IPMN become the first indication of LPD (12%, 39%, 34%; p=0.037) followed by ampulloma (30%, 9%, 20%), less resection for pancreatic adenocarcinoma (35%, 16%, 16%; p=0.004), and more dilated (>3mm) wirsung duct > 3 mm (16%, 27% and 57%; p< 0.001). The third period showed less operative time (330, 345, 270; p< 0.001) and blood loss (300, 200 125; p< 0.001). Similar mortality (4%, 4%, 2%; p=0.53), decrease in all complications including mainly grades B/C PF (44%, 28%, 20%; p=0.017), bleeding (28% ,21%, 14%, p=0.26), re-intervention (19%, 14%, 9%; p=0.43) and hospital stay (26, 19, 18; p=0.045). In patients with adenocarcinoma (n=69), similar tumor size but more harvested lymph nodes (21, 19, 25; p=0.031) and R0 resection (70%, 79%, 84%; p=0.5). On multivariate analysis protective factors against grades B/C PF were female gender, pancreatic adenocarcinoma, BMI < 22.5 and the third period. Conclusion: With patient selection and the learning curve, the results of LPD are improved. These results are important for the safe implementation of this technique." @default.
- W3143403978 created "2021-04-13" @default.
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- W3143403978 date "2021-01-01" @default.
- W3143403978 modified "2023-10-16" @default.
- W3143403978 title "The Outcome of Laparoscopic Pancreaticoduodenectomy Is Improved with the Learning Curve and Patients' Selection. Analysis in 130 Patients" @default.
- W3143403978 doi "https://doi.org/10.1016/j.hpb.2020.11.178" @default.
- W3143403978 hasPublicationYear "2021" @default.
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