The Inflammatory Response and Long-Term Outcomes Between Open and Laparoscopic Pancreatoduodenectomy:A Propensity-Matched Single-Institution Study

J Laparoendosc Adv Surg Tech A. 2024 Oct;34(10):882-889. doi: 10.1089/lap.2024.0006. Epub 2024 Jul 8.

Abstract

Background: In recent years, although laparoscopic pancreatoduodenectomy (LPD) has experienced rapid development both domestically and internationally, however, there are still varying opinions toward LPD. Methods: From January 2020 to July 2022, the data were collected. We compared the inflammatory response at various postoperative time points and evaluated long-term outcomes between the two groups. Results: In the early stage, the LPD group exhibited lower values of white blood cells, C-reactive protein, neutrophils, and platelets after surgery compared with open pancreatoduodenectomy (OPD) (P all<0.05). However, no statistically significant differences were observed in terms of procalcitonin, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. Before propensity score matching, no statistical significance was observed between two groups, whether in terms of disease-free survival (DFS) (P = .406) or overall survival (OS) (P = .851). However, to further control for confounding factors, propensity score matching was used. The analysis revealed that DFS still showed no significant difference (P = .928), but, in the term of OS, a statistical significance was observed between the two groups. Conclusion: LPD demonstrates a comparable long-term outcomes to OPD and even slightly superior OS. Moreover, the LPD group exhibits a lower inflammatory response during early postoperative period.

Keywords: a propensity-matched; inflammatory response; open and laparoscopic pancreaticoduodenectomy; short-term and long-term outcome.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Female
  • Humans
  • Inflammation
  • Laparoscopy* / methods
  • Male
  • Middle Aged
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery
  • Pancreaticoduodenectomy* / adverse effects
  • Pancreaticoduodenectomy* / methods
  • Postoperative Complications / epidemiology
  • Propensity Score*
  • Retrospective Studies
  • Treatment Outcome