Min Young Park, MD, Woo Hyung Lee, MD, PhD, Ki Byung Song, MD, PhD, Dae Wook Hwang, MD, PhD, Jae Hoon Lee, MD, PhD, Young Joo Lee, MD, PhD, Song Cheol Kim, MD, PhD. Asan Medical Center
Background: Checking invasion of SMA have a decisive effect on proceeding the surgery for pancreatic head cancer. Although previous studies showed that SMA-first approach (SFA) technique was feasible, laparoscopic procedures of SFA were not spread for surgeons. This study was aimed to compare the perioperative outcomes between laparoscopic and open SFA for pancreatic head cancer.
Methods: Between January 2017 and December 2018, consecutive patients who underwent laparoscopic and open pylorus preserving pancreaticoduodenectomy (PPPD) using SFA procedures were found. Collected clinicopathologic data were compared between laparoscopic and open procedures.
Results: There were 11 patients who underwent laparoscopic surgery and 57 patients who underwent open surgery. There were no significant differences in age (median age 65 vs 65, p = 0.461) and ratio of patients who had neoadjuvant chemotherapy (27.3% vs 14.0%, p=0.28) between laparoscopic and open surgery. In perioperative outcomes, there were no significant differences in intraoperative blood loss (p = 0.53), intraoperative transfusion rate (9.1 % vs 17.5 %, p = 0.49), R0 resection (81.8 % vs 78.9 %, p = 0.83) and postoperative complication rate (36.4 % vs 47.4 %, p=0.50) between two groups. There were differences in BMI (20.9 vs 23.0, p = 0.015) and operation time (434 min vs 328 min, p < 0.001) between two groups. Also number of harvested lymph nodes (16 vs 22, p=0.048) showed difference but it was marginal.
Conclusion: Postoperative complications and pathologic results were not different clearly between laparoscopic and open SFA groups. Laparoscopic SFA can be considerable procedures in laparoscopic PPPD for pancreatic head cancer.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98821
Program Number: ETP713
Presentation Session: Emerging Technology Poster Session (Non CME)
Presentation Type: Poster