INTRODUCTION

MATERIALS AND METHODS
Case series
Surgical procedure

RESULTS
Table 1
n or mean | % or range | |
---|---|---|
Men | 11 | 53.3% |
Age (years) | 67.9 | 43-84 |
BMI (kg/m2) | 24.5 | 20.7-32 |
ASA | ||
II | 7 | 33 |
III | 14 | 67 |
Tumor Size (mm) | 21 | 15-55 |
Vascular invasion | 3 | 14.2 |
Neoadjuvant therapy | 11 | 73.3 |
Operative time (minutes) | 425 | 226-576 |
Conversion to open surgery | 4 | 19 |
Estimated blood loss (ml) | 317 | 60-800 |
Intraoperative transfusion | 3 | 14.2 |
Total post-operative complications | 9 | 42.8 |
Major post-operative complication* | 3 | 14.2 |
Pancreatic fistula | 4 | 19 |
Grade B | 3 | 14.3 |
Grade C | 1 | 4.7 |
Post-pancreatectomy hemorrhage | 1 | 4.7 |
Delayed gastric emptying | 4 | 19 |
Bile leak | 2 | 9.5 |
Pulmonary embolism | 2 | 9.5 |
Reoperation | 1 | 4.7 |
Length of hospital stay (days) | 14 | 9-23 |
90-days readmission | 4 | 19 |
90-days mortality | 1 | 4.7 |
Histologic subtype | ||
Adenocarcinoma | 15 | 71.4 |
AAC | 2 | 9.5 |
IPMN | 2 | 9.5 |
CA | 1 | 4.8 |
DA | 1 | 4.8 |
Number of harvested LN | 17.7 | 12-26 |
Invaded LN | 1.7 | 1-7 |
R0 rate | 17 | 80 |
R1 >0<1 mm | 2 | 9.5 |
R1 0 mm | 2 | 9.5 |
Postoperative chemotherapy | 15 | 71.4 |
Follow-up (months) | 7.5 | 3-12 |

DISCUSSION
Table 2
Author Study period Study type | Tot pts (disease) Open L | OR time mean | Blood loss ml | CD>3 | Reoperation <30 d | POPF | PPH | DGE | Lymph nodes number | R0 | Length of stay Mean days | Mortality <30 d |
---|---|---|---|---|---|---|---|---|---|---|---|---|
2009 - Cho et al.20 (2007-2008) Prospective |
T 30 (M): O 15 LA 15 (Mes) |
NS L 338 O 287 |
NS L 445 O 552 |
NS |
NS L 13% O 13% |
NS L 7% O 0% |
NS L 18 O 20 |
NS |
NS L 16.4 O 15.6 |
|||
2011 - Zureikat et al.34 (2006-2010) Retrospective |
T 28 (M): O 14 TL 14 (Mes) |
Open L 456 O 372 |
NS L 300 O 400 |
NS L 7% O 7% |
NS L 36% O 42.8% |
NS |
NS L 18 O 19 |
NS L 100% O 91.7% |
NS L 8 O 8.5 |
NS L 7% O 0% |
||
2012 - Asbun and Stauffer35 (2005-2011) Retrospective |
T 268 (M): O 215 TL 53 (Std) |
Open O 401 L 541 |
L O 1,032 L 195 |
NS O 24.% L 24.5% |
NS O 7% L 3.8% |
NS O 17.3% L 16.7% |
NS O 5.6% L 9.4% |
NS O 15.3% L 11.3% |
L O 16 L 23 |
NS O 83% L 94.9% |
L O 12 L 8 |
NS O 8.8% L 5.7% |
2013 - Mesleh et al.36 (2009-2012) Cost analysis |
T 123 (NM): O 75 TL 48 (NM) |
Open O 355 L 551 |
NS |
NS O 31% L 31% |
NS O 2% L 4% |
NS O 6% L 9% |
NS |
NS O 8% L 13% |
NS | NS |
NS O 8 L 7 |
NS |
2014 - Hakeem et al.37 (2005-2009) Retrospective |
T 24 (Ca): O 12 TL 12 (Std) |
NS L 16.7% O 50% |
NS L 16.7% O 8.3% |
NS L 20 O 18 |
NS L 75% O 66.7% |
NS L 14.9 O 14.9 |
NS L 0% O 0% |
|||||
2014 - Langan et al.15 (2010-2013) Retrospective |
T 53 (M): O 25 LA 28 (Std) |
NS O 347 L 355 |
NS O 454 L 336 |
L O 9.4 L 7.1 |
||||||||
2014 - Wang et al.21 (2009-2013) Retrospective |
T 33 (M): O 20 LA 13 (Std) |
Open LA 594 O 553 (303-892) |
L LA 450 O 1000 |
NS LA 2% O 8% |
NS LA 4% O 6% |
NS | NS |
NS LA 22 O 20 |
NS LA 70% O 53% |
L LA 8 O 12 |
NS LA 8% O 20% |
|
2014 - Wellner et al.38 (2010-2013) Retrospective |
T 80 (NM): O 40 LA 40 (Std) |
NS O 410 LA 343 |
Lap |
NS O 7% LA 10% |
NS O 7% LA 10% |
NS O 11% LA 7% |
NS O 3% LA 5% |
NS O 11% LA 5% |
NS O 19 LA 15 |
NS |
NS O 16 LA 14 |
NS O 0% LA 1% |
2015 - Croome et al.23 (2008-2013) Retrospective |
T 322(PDAC): O 214 TL 108 (Mes) |
NS TL 379.4 O 387.6 |
L TL 492 O 866 |
NS TL 5.6% O 13.6% |
NS |
NS TL 11% O 12% |
NS TL 7% O 6% |
NS TL 9% O 18% |
NS TL 21 O 20 |
NS TL 77.8% O 76.6% |
L TL 6 O 9 |
NS TL 1% O 2% |
2015 - Adam et al.39 (2010-2011) Retrospective |
T 7061 (Ca): O 6078 TL, TR 983 (NM) |
NS | NS | NS | Open RR 1.87 | |||||||
2015 - Dokmak et al.24 (2011-2014) Prospective |
T 92 (M): O 46 TL LA 46 (Std) |
Open L 342 O 264 |
NS L 368 O 293 |
NS L 28% O 20% |
NS L 24% O 11% |
Open L 24% O 6% |
Open L 24% O 7% |
NS L 17% O 15% |
NS L 25 O 23 |
NS L 2% O 0% |
||
2015 - Liang and Jayaraman40 (2011-2013) Retrospective |
T 44 (M): O 29 TL,LA 15 (Std) |
NS L 342 O 358 |
NS |
NS L 33% O 17% |
NS |
NS L 20% O 14% |
NS L 9 O 14 |
NS L 100% O 90% |
NS L 8 O 9 |
|||
2015 - Sharpe et al.18 (2010-2011) Retrospective |
T 4421 (PDAC): O 4037 TL 384 (NM) |
L O 15 L 17 |
L O 74% L 80% |
L O 12 L 10 |
NS O 3.7% L 5.2% |
|||||||
2015 - Song et al.41 (2007-2012) Case control |
T 2192 (Ca): O 1524 TL 137 (Std) |
Open L 480.4 O 351.9 |
NS L 592 O 555 |
NS L 8.2% O 7.1% |
NS |
NS L 6.3% O 7.5% |
NS |
NS L 3.2% O 7.5% |
NS L 15 O 16.2 |
NS L 72.7% O 81% |
L L 14.1 O 20 |
NS |
2015 - Tan et al.42 (2009-2014) Retrospective |
T 60 (NM): O 30 TL 30 (Std) |
Open TL 513 O 371.67 |
NS | NS | NS |
NS TL 10% O 6% |
NS TL 1% O 1% |
NS |
NS TL 8 O 9 |
NS |
L TL 10 O 11.8 |
NS TL 0% O 1% |
2016 - Delitto et al.43 (2010-2014) Cohort |
T 102 (Ca): O 50 TL 52 (NM) |
NS L 361 O 360 |
L L 260 O 518 |
NS L 25% O 32% |
NS |
L L 17% O 36% |
NS L 10% O 6% |
NS |
NS L 23 O 20 |
L L 90.4% O 74% |
L L 9. O 11.9 |
NS L 2% O 0% |
2017 - Stauffer et al.44 (1995-2014) Retrospective |
T 251 (PDAC): O 193 TL 58 (Std) |
Open O 375 L 518 |
L O 600 L 250 |
NS O 30.1% L 22.4% |
NS O 6.2% L 1.7% |
NS O 12.3% L 11.8% |
NS O 4.1% L 6.9% |
NS O 14.5% L 17.2% |
L O 17 L 27 |
L O 9 L 6 |
NS O 5.2% L 3.4% |
|
2017 - Conrad et al.45 (2000-2010) Propensity score |
T 65 (PDAC): O 25 TL 40 (NM) |
NS | NS |
NS L 70% O 68% |
NS |
NS L 30.5% O 42% |
NS | NS |
NS L 20 O 17 |
NS L 84.1% O 85.8% |
NS L 23 O 28 |
NS |
2017 - Palanivelu et al.6 (2013-2015) RCT |
T 64 (Ca): O 32 TL 32 (Std) |
Open O 320 L 359 |
L O 401 L 250 |
NS O 10% L 8% |
NS O 1% L 1% |
NS O 6% L 5% |
NS O 4% L 3% |
NS O 7% L 5% |
NS O 17 L 18 |
NS O 94% L 97% |
L O 13 L 7 |
NS O 1% L 1% |
2018 - Chapman et al.26 (2012-2016) Retrospective |
T 47 (Amp): O 25 TL 22 (Std) |
Open TL 314 O 359 |
L TL 300 O 500 |
NS | NS |
NS TL 36.4% O 28.0% |
NS |
NS TL 27.3% O 32.0% |
NS TL 19 O 15 |
NS TL 100% 0 100% |
NS TL 11.5 O 9 |
NS TL 0% O 0% |
2018 - Meng et al.46 (2010-2015) Retrospective |
T 116 (NM): O 58 TL 58 (NM) |
Open L 475 O 335 |
NS L 200 O 220 |
NS |
NS L 15.52% O 15.52% |
NS L 55.17% O 58.62% |
NS L 8.62% O 8.62% |
NS L 15.52% O 15.52% |
NS L 16 O 15 |
NS L 100.0% O 94.83% |
NS L 14 O 13 |
NS L 1.72% O 1.72% |
2018 - Chen et al.47 (2013-2017) Retrospective |
T 102 (M): O 55 TL 47 (AF) |
Open L 410 O 245 |
L L 210 O 420 |
NS L 4.26% O 5.45% |
NS |
NS L 12.8% O 14.5% |
NS L 2.13% O 3.63% |
NS L 4.26% O 3.63% |
NS L 20 O 19 |
NS L 100% O 100% |
L L 13 O 18±5.5 |
NS L 0% O 0% |
2018 - Deichman et al.11 (2000-2015) Prospective |
T 120 (M): O 60 LA 60 (NM) |
L L 352 O 397 |
lap |
NS L 22% O 20% |
L L 15% O 36% |
NS L 8% O 13% |
L L 8% O 20% |
NS L 13 O 16 |
NS |
L L 14 O 18 |
NS L 0% O 3% |
|
2018 - Poves et al.7 (2013-2017) RCT |
T 66 (M): O 32 TL, LA 34 (NM) |
Open |
L O 37% L 0% |
NS O 7.3% L 0% |
NS O 21.9% L 15.4% |
NS O 9.8% L 7.7% |
NS O 24.4% L 7.7% |
NS | NS |
L O 21 L 14 |
Lap O 2.4% L 0% |
|
2019 - Van Hilst et al.8 (2016-2017) RCT |
T 99 (M): O 49 TL 50 (NM) |
Open L 410 O 274 |
NS L 300 O 450 |
NS L 50% O 39% |
NS L 12% O 6% |
NS L 28% O 24% |
NS L 10% O 14% |
NS L 34% O 20% |
NS L 11 O 11 |
NS L 82% O 76% |
NS L 11 O 10 |
Open L 10% O 2% |
M, mixed tumors; Ca, cancer; Mes, mesenteric approach; Std, standard approach; T, total number of patients; POPF, postoperative pancreatic fistula; PPH, postpancreatectomy hemorrhage; DGE, delayed gastric emptying; CD>3, clavien-dindo grade>3; PDAC, pancreatic ductal adenocarcinoma; O, open; L, laparoscopic; NM, not mentioned; TL, totally laparoscopic; LA, laparoscopically assisted; NS, not significant
