A study published in JAMA Surgery has found that laparoscopic pancreaticoduodenectomy (LPD) offers similar short-term outcomes compared to open surgery for patients with pancreatic ductal adenocarcinoma (PDAC). The study, conducted by Min Wang, MD, and colleagues from Huazhong University of Science and Technology, was an investigator-initiated, multicenter, parallel-group, open-label study involving 200 patients with PDAC.
Key findings of the study include:
Operative Times and Blood Loss: Patients undergoing LPD experienced longer median operative times (330 minutes) compared to those undergoing open pancreaticoduodenectomy (PD) (297 minutes). However, LPD patients had less blood loss (median 145 mL) than those in the open PD group (median 200 mL).
Postoperative Complications and Mortality: The overall postoperative morbidity rate was comparable between the LPD (46%) and open PD (54%) groups. The comprehensive complication index scores were similar, with no significant differences in rates of severe complications (Clavien-Dindo grade III or greater) or median postoperative length of stay (14 days for both groups). The study reported two deaths within 90 days post-procedure in the LPD group, compared to none in the open PD group.
Reoperation and Readmission Rates: Rates of reoperation (3% for LPD vs. 2% for open PD) and 90-day readmission (0% for LPD vs. 2% for open PD) were not significantly different between the two groups.
The study concludes that LPD for PDAC, when performed by skilled surgeons, provides similar short-term safety outcomes as open PD. The in-hospital recovery after laparoscopic surgery was found to be noninferior to that after open surgery. However, long-term follow-up is necessary to assess the oncological safety of laparoscopic resection in patients with PDAC.