> Details

Uijterwijk, Bas A.; Lemmers, Daniël H.L.; Bolm, Louisa; Luyer, Misha; Koh, Ye Xin; Mazzola, Michele; Webber, Laurence; Kazemier, Geert; Bannone, Elisa; Ramaekers, Mark; Ielpo, Benedetto; Wellner, Ulrich; Koek, Sharnice; Giani, Alessandro; Besselink, Marc G.; Abu Hilal, Mohammed

Long-term Outcomes After Laparoscopic, Robotic, and Open Pancreatoduodenectomy for Distal Cholangiocarcinoma : An International Propensity Score-matched Cohort Study

Reference
management

Bookmarks

Remove from
bookmarks

Share this on Whatsapp

Close

Bookmarks



You can manage bookmarks using lists, please log in to your user account for this.
  • Media type: E-Article
  • Title: Long-term Outcomes After Laparoscopic, Robotic, and Open Pancreatoduodenectomy for Distal Cholangiocarcinoma : An International Propensity Score-matched Cohort Study : An International Propensity Score-matched Cohort Study
  • Contributor: Uijterwijk, Bas A.; Lemmers, Daniël H.L.; Bolm, Louisa; Luyer, Misha; Koh, Ye Xin; Mazzola, Michele; Webber, Laurence; Kazemier, Geert; Bannone, Elisa; Ramaekers, Mark; Ielpo, Benedetto; Wellner, Ulrich; Koek, Sharnice; Giani, Alessandro; Besselink, Marc G.; Abu Hilal, Mohammed
  • imprint: Ovid Technologies (Wolters Kluwer Health), 2023
  • Published in: Annals of Surgery
  • Language: English
  • DOI: 10.1097/sla.0000000000005743
  • ISSN: 0003-4932
  • Origination:
  • Footnote:
  • Description: <jats:sec> <jats:title>Objective:</jats:title> <jats:p>This study aimed to compare surgical and oncological outcomes after minimally invasive pancreatoduodenectomy (MIPD) versus open pancreatoduodenectomy (OPD) for distal cholangiocarcinoma (dCCA).</jats:p> </jats:sec> <jats:sec> <jats:title>Background:</jats:title> <jats:p>A dCCA might be a good indication for MIPD, as it is often diagnosed as primary resectable disease. However, multicenter series on MIPD for dCCA are lacking.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods:</jats:title> <jats:p>This is an international multicenter propensity score-matched cohort study including patients after MIPD or OPD for dCCA in 8 centers from 5 countries (2010-2021). Primary outcomes included overall survival (OS) and disease-free interval (DFI). Secondary outcomes included perioperative and postoperative complications and predictors for OS or DFI. Subgroup analyses included robotic pancreatoduodenectomy (RPD) and laparoscopic pancreatoduodenectomy (LPD).</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>Overall, 478 patients after pancreatoduodenectomy for dCCA were included of which 97 after MIPD (37 RPD, 60 LPD) and 381 after OPD. MIPD was associated with less blood loss (300 vs 420 mL, <jats:italic toggle="yes">P</jats:italic>=0.025), longer operation time (453 vs 340 min; <jats:italic toggle="yes">P</jats:italic>&lt;0.001), and less surgical site infections (7.8% vs 19.3%; <jats:italic toggle="yes">P</jats:italic>=0.042) compared with OPD. The median OS (30 vs 25 mo) and DFI (29 vs 18) for MIPD did not differ significantly between MIPD and OPD. Tumor stage (Hazard ratio: 2.939, <jats:italic toggle="yes">P</jats:italic>&lt;0.001) and administration of adjuvant chemotherapy (Hazard ratio: 0.640, <jats:italic toggle="yes">P</jats:italic>=0.033) were individual predictors for OS. RPD was associated with a higher lymph node yield (18.0 vs 13.5; <jats:italic toggle="yes">P</jats:italic>=0.008) and less major morbidity (Clavien-Dindo 3b-5; 8.1% vs 32.1%; <jats:italic toggle="yes">P</jats:italic>=0.005) compared with LPD.</jats:p> </jats:sec> <jats:sec> <jats:title>Discussion:</jats:title> <jats:p>Both surgical and oncological outcomes of MIPD for dCCA are acceptable as compared with OPD. Surgical outcomes seem to favor RPD as compared with LPD but more data are needed. Randomized controlled trials should be performed to confirm these findings.</jats:p> </jats:sec>