Extended Pancreatic Transection Versus Conventional Pancreatic Transection During Laparoscopic Pancreaticoduodenectomy
Study Details
Study Description
Brief Summary
The level of pancreatic neck transection during laparoscopic pancreaticoduodenectomy (LPD) is not conclusive. Theoretically, the level of pancreatic transection can significantly affect the occurrence of postoperative pancreatic fistula (POPF) by influencing both the blood supply to the anastomosis and the location of the main pancreatic duct in the pancreatic transverse section. The investigators conduct a retropective propensity score-matched comparison to compare the impact of extended pancreatic transection and conventional pancreatic transection on POPF and the performance of the pancreaticojejunostomy during LPD.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| extended pancreatic transection cohort cases in which the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan. |
Procedure: extended pancreatic transection during laparoscopic pancreaticoduodenectomy
the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy
|
| conventional pancreatic transection cohort cases in which the pancreatic transection was performed at the pancreatic neck above the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan. |
Outcome Measures
Primary Outcome Measures
- the incidence of clinically relevant pancreatic fistula [3 months postoperatively]
the incidence of the clinically relevant pancreatic fistula according the International Study Group of Pancreatic Surgery's definition and grading
Secondary Outcome Measures
- surgical performance of pancreaticojejunostomy [intraoperatively]
the duration of pancreaticojejunostomy
- postoperative morbidity [3 months postoperatively]
postoperative morbidity (Clavien-Dindo score ≥3) within 3 months postoperatively
- postoperative mortality [3 months postoperatively]
mortality within 3 months postoperatively
Eligibility Criteria
Criteria
Inclusion Criteria:
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consecutive patients underwent elective laparoscopic pancreaticoduodenectomy within October 2019 to April 2023
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the perioperative and follow-up study data information can be collected completely
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The level of pancreatic neck dissection can be determined by postoperative abdominal CT
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patients without the history of neoadjuvant chemotherapy or radiotherapy
Exclusion Criteria:
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conversion to laparotomy due to various reasons during operation;
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combined with resection and reconstruction of the portal vein or the superior mesenteric vein
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combined with other organ resection
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the perioperative and follow-up study data information can not be collected completely, or the level of pancreatic neck dissection can not be determined by postoperative abdominal CT
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patients with the history of neoadjuvant chemotherapy or radiotherapy
Contacts and Locations
Locations
No locations specified.Sponsors and Collaborators
- Xinrui Zhu，MD
Investigators
- Study Chair: Bing Peng, West China Hospital
Study Documents (Full-Text)
None provided.More Information
Publications
- Bardol T, Delicque J, Hermida M, Herrero A, Guiu B, Fabre JM, Souche R. Neck transection level and postoperative pancreatic fistula after pancreaticoduodenectomy: A retrospective cohort study of 195 patients. Int J Surg. 2020 Oct;82:43-50. doi: 10.1016/j.ijsu.2020.08.001. Epub 2020 Aug 22.
- Jwa EK, Hwang S. Extended pancreatic transection for secure pancreatic reconstruction during pancreaticoduodenectomy. Ann Hepatobiliary Pancreat Surg. 2017 Aug;21(3):138-145. doi: 10.14701/ahbps.2017.21.3.138. Epub 2017 Aug 31.
- Strasberg SM, Drebin JA, Mokadam NA, Green DW, Jones KL, Ehlers JP, Linehan D. Prospective trial of a blood supply-based technique of pancreaticojejunostomy: effect on anastomotic failure in the Whipple procedure. J Am Coll Surg. 2002 Jun;194(6):746-58; discussion 759-60. doi: 10.1016/s1072-7515(02)01202-4.
- 2023-167-2