한국간담췌외과학회지 (Annals of Hepato-Biliary-Pancreatic Surgery)

  • 제27권3호
  • /
  • Pages.292-300
  • /
  • 2023
  • /
  • 2508-5778(pISSN)
  • /
  • 2508-5859(eISSN)
한국간담췌외과학회 (The Korean Association of Hepato-Biliary-Pancreatic Surgery)
권호 표지
DOI QR코드

DOI QR Code

Impact of conversion at time of minimally invasive pancreaticoduodenectomy on perioperative and long-term outcomes: Review of the National Cancer Database

  • Jennifer Palacio (Department of General Surgery, Memorial Healthcare System) ;
  • Daisy Sanchez (Department of General Surgery, Memorial Healthcare System) ;
  • Shenae Samuels (Office of Human Research, Memorial Healthcare System) ;
  • Bar Y. Ainuz (Herbert Wertheim College of Medicine, Florida International University) ;
  • Raelynn M. Vigue (Herbert Wertheim College of Medicine, Florida International University) ;
  • Waleem E. Hernandez (Herbert Wertheim College of Medicine, Florida International University) ;
  • Christopher J. Gannon (Division of Surgical Oncology, Memorial Healthcare System) ;
  • Omar H. Llaguna (Division of Surgical Oncology, Memorial Healthcare System)
  • 투고 : 2022.10.17
  • 심사 : 2023.01.25
  • 발행 : 2023.08.31
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Backgrounds/Aims: Current literature presents limited data regarding outcomes following conversion at the time of minimally invasive pancreaticoduodenectomy (MI-PD). Methods: The National Cancer Database was queried for patients who underwent pancreaticoduodenectomy. Patients were stratified into three groups: MI-PD, converted to open pancreaticoduodenectomy (CO-PD), and open pancreaticoduodenectomy (O-PD). Multivariable modeling was applied to compare outcomes of MI-PD and CO-PD to those of O-PD. Results: Of 17,570 patients identified, 12.5%, 4.2%, and 83.4% underwent MI-PD, CO-PD, and O-PD, respectively. Robotic pancreaticoduodenectomy (R-PD) resulted in a higher lymph node yield (n = 23.2 ± 12.2) even when requiring conversion (n = 22.4 ± 13.2, p < 0.001). Margin positivity was higher in the CO-PD group (26.6%) than in the MI-PD group (21.3%) and the O-PD (22.6%) group (p = 0.017). Length of stay was shorter in the MI-PD group (laparoscopic pancreaticoduodenectomy 10.4 ± 8.6, R-PD 10.6 ± 8.8) and the robotic converted to open group (10.7 ± 6.4) than in the laparoscopic converted to open group (11.2 ± 9) and the O-PD group (11.5 ± 8.9) (p < 0.001). After adjusting for patient and tumor characteristics, both MI-PD (odds ratio = 1.40; p < 0.001) and CO-PD (odds ratio = 1.24; p = 0.020) were significantly associated with an increased likelihood of long-term survival. Conclusions: CO-PD does not negatively impact perioperative or oncologic outcomes.

키워드

과제정보

Abstract presented at Americas Hepato-Pancreato-Biliary Association Annual Meeting, Miami Beach, FL, 2021. International Hepato-Pancreato-Biliary Association World Conference, New York City, NY, 2022.

참고문헌

  1. Cuschieri A, Jakimowicz JJ, van Spreeuwel J. Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. Ann Surg 1996;223:280-285.  https://doi.org/10.1097/00000658-199603000-00008
  2. Wright GP, Zureikat AH. Development of minimally invasive pancreatic surgery: an evidence-based systematic review of laparoscopic versus robotic approaches. J Gastrointest Surg 2016;20:1658-1665.  https://doi.org/10.1007/s11605-016-3204-1
  3. Liang S, Hameed U, Jayaraman S. Laparoscopic pancreatectomy: indications and outcomes. World J Gastroenterol 2014;20:14246-14254.  https://doi.org/10.3748/wjg.v20.i39.14246
  4. Cuschieri SA, Jakimowicz JJ. Laparoscopic pancreatic resections. Semin Laparosc Surg 1998;5:168-179.  https://doi.org/10.1177/155335069800500303
  5. Tan-Tam C, Chung SW. Minireview on laparoscopic hepatobiliary and pancreatic surgery. World J Gastrointest Endosc 2014;6:60-67.  https://doi.org/10.4253/wjge.v6.i3.60
  6. Boggi U, Amorese G, Vistoli F, Caniglia F, De Lio N, Perrone V, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc 2015;29:9-23.  https://doi.org/10.1007/s00464-014-3670-z
  7. Caba Molina D, Lambreton F, Arrangoiz Majul R. Trends in robotic pancreaticoduodenectomy and distal pancreatectomy. J Laparoendosc Adv Surg Tech A 2019;29:147-151.  https://doi.org/10.1089/lap.2018.0421
  8. Zureikat AH, Breaux JA, Steel JL, Hughes SJ. Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg 2011;15:1151-1157.  https://doi.org/10.1007/s11605-011-1530-x
  9. Gumbs AA, Rodriguez Rivera AM, Milone L, Hoffman JP. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol 2011;18:1335-1341.  https://doi.org/10.1245/s10434-010-1503-4
  10. Kausch W. [Das Carcinom der Papilla duodeni und seine radikale Entfernung]. Beitr Z Klin Chir 1912;78:439-486. German. 
  11. Whipple AO, Parsons WB, Mullins CR. Treatment of carcinoma of the ampulla of Vater. Ann Surg 1935;102:763-779.  https://doi.org/10.1097/00000658-193510000-00023
  12. Adam MA, Choudhury K, Dinan MA, Reed SD, Scheri RP, Blazer DG 3rd, et al. Minimally invasive versus open pancreaticoduodenectomy for cancer: practice patterns and short-term outcomes among 7061 patients. Ann Surg 2015;262:372-377.  https://doi.org/10.1097/SLA.0000000000001055
  13. Pedziwiatr M, Malczak P, Pisarska M, Major P, Wysocki M, Stefura T, et al. Minimally invasive versus open pancreatoduodenectomy-systematic review and meta-analysis. Langenbecks Arch Surg 2017;402:841-851.  https://doi.org/10.1007/s00423-017-1583-8
  14. Nassour I, Winters SB, Hoehn R, Tohme S, Adam MA, Bartlett DL, et al. Long-term oncologic outcomes of robotic and open pancreatectomy in a national cohort of pancreatic adenocarcinoma. J Surg Oncol 2020;122:234-242.  https://doi.org/10.1002/jso.25958
  15. Zhang J, Wu WM, You L, Zhao YP. Robotic versus open pancreatectomy: a systematic review and meta-analysis. Ann Surg Oncol 2013;20:1774-1780.  https://doi.org/10.1245/s10434-012-2823-3
  16. Nassour I, Wang SC, Porembka MR, Augustine MM, Yopp AC, Mansour JC, et al. Conversion of minimally invasive distal pancreatectomy: predictors and outcomes. Ann Surg Oncol 2017;24:3725-3731.  https://doi.org/10.1245/s10434-017-6062-5
  17. Yerokun BA, Adam MA, Sun Z, Kim J, Sprinkle S, Migaly J, et al. Does conversion in laparoscopic colectomy portend an inferior oncologic outcome? Results from 104,400 patients. J Gastrointest Surg 2016;20:1042-1048.  https://doi.org/10.1007/s11605-016-3073-7
  18. Nassour I, Paniccia A, Moser AJ, Zureikat AH. Minimally invasive techniques for pancreatic resection. Surg Oncol Clin N Am 2021;30:747-758.  https://doi.org/10.1016/j.soc.2021.06.007
  19. Van Hilst J, de Graaf N, Abu Hilal M, Besselink MG. The landmark series: minimally invasive pancreatic resection. Ann Surg Oncol 2021;28:1447-1456. https://doi.org/10.1245/s10434-020-09335-3