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Comparison of postoperative complications and long-term oncological outcomes in minimally invasive versus open pancreatoduodenectomy for distal cholangiocarcinoma: A propensity score-matched analysis

Authors
 Sung Hyun Kim  ;  Boram Lee  ;  Ho Kyoung Hwang  ;  Jun Suh Lee  ;  Ho-Seong Han  ;  Woo Jung Lee  ;  Yoo-Seok Yoon  ;  Chang Moo Kang 
Citation
 JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, Vol.29(3) : 329-337, 2022-03 
Journal Title
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
ISSN
 1868-6974 
Issue Date
2022-03
MeSH
Bile Duct Neoplasms* / surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma* / surgery ; Humans ; Laparoscopy* / adverse effects ; Pancreaticoduodenectomy / adverse effects ; Pancreaticoduodenectomy / methods ; Postoperative Complications / etiology ; Propensity Score ; Retrospective Studies ; Treatment Outcome
Keywords
distal cholangiocarcinoma ; minimally invasive surgical procedure ; pancreatoduodenectomy ; postoperative complications ; survival
Abstract
Background: Pancreatoduodenectomy (PD) is the only curative therapy for distal cholangiocarcinoma (dCC). There has been no study to compare outcomes between minimally invasive pancreatoduodenectomy (MIPD) and open pancreatoduodenectomy (OPD) for dCC. The aim of the study is to compare the two operation types for dCC in terms of postoperative and oncologic outcomes.

Methods: Data from 426 patients who underwent MIPD (n = 91) or OPD (n = 335) for dCC from January 2012 to December 2019 at two tertiary hospitals were retrospectively reviewed. After 1:2 propensity score matching, postoperative and oncologic outcomes were compared.

Results: Minimally invasive pancreatoduodenectomy group showed more favorable results than OPD group in terms of blood loss (MIPD vs OPD, 250 [150-400] vs 400 [200-600], mL, P < .001), and length of hospital stay (19.8 ± 11.3 vs 26.6 ± 14.3 days, P < .001). OPD group showed more favorable results than MIPD group in terms of operation time (MIPD vs OPD, 457 ± 70 vs 398 ± 85 min, P < .001) and harvested lymph nodes (14.9 ± 7.8 vs 20.7 ± 11.5, P < .001). There was no statistical difference between the two groups in the R0 resection rate and complications. In long-term survival analysis, there was no significant difference between the two groups.

Conclusion: Minimally invasive pancreatoduodenectomy showed comparable postoperative complications and long-term oncologic survival with OPD in the treatment of dCC.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.1067
DOI
10.1002/jhbp.1067
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Kim, Sung Hyun(김성현) ORCID logo https://orcid.org/0000-0001-7683-9687
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Hwang, Ho Kyoung(황호경) ORCID logo https://orcid.org/0000-0003-4064-7776
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188346
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