Patients with pancreatic cancer who underwent pancreatoduodenectomy, also known as the Whipple procedure, experienced shorter hospital stays with laparoscopic vs. open surgery in a randomized controlled trial.
While both types of procedures resulted in similar overall complications and outcomes, patients who underwent the laparoscopic procedure experienced less blood loss, and fewer blood transfusions and surgical site infections in addition to shorter length of stay.
“Major surgeries like cancer operations performed with a laparoscopic approach offer significant advantages to patients,” Chinnusamy Palanivelu, MD, of the department of surgical gastroenterology and hepatopancreatobiliary surgery at GEM Hospital and Research Center in India, said in a press release.
Due to a lack of randomized controlled trial data comparing open vs. laparoscopic pancreatoduodenectomy, Palanivelu and colleagues randomly assigned 64 patients with periampullary cancers to undergo either procedure, and evaluated length of hospital stay as the primary outcome. Key secondary outcomes included blood loss, radicality of surgery, procedure length and complication rate.
They found that open surgeries resulted in longer hospital stays compared with laparoscopic surgeries (median, 13 vs. 7 days; P = .001).
Additionally, patients who underwent open surgery had significantly greater blood loss (mean, 401 vs. 250 mL; P < .001), and more blood transfusions (7 vs. 3; P = .034).
Both approaches resulted in similar postoperative complications, with only the rate of surgical site infection being significantly greater in the open surgery group (8 vs. 4; P = .015).
Finally, the laparoscopic procedures were longer in duration (mean, 359 vs. 320 minutes; P = .041).
“The benefits of laparoscopic pancreatoduodenectomy in terms of disease-free survival and long-term survival were not investigated,” Palanivelu and colleagues noted. They concluded that the study showed “a significant advantage for the laparoscopic group in terms of shortened median duration of postoperative hospital stay, which was decreased by half compared with that of open surgery.” – by Adam Leitenberger
Disclosures: The authors report no relevant financial disclosures.