Laparoscopic versus open distal pancreatectomy for pancreatic adenocarcinoma: a systematic review and meta-analysis

Acta chirurgica Belgica
Paschalis GavriilidisRobert P Sutcliffe

Abstract

To compare the effectiveness, safety and oncologic adequacy of laparoscopic and open distal pancreatectomy (ODP) for pancreatic adenocarcinoma. A systematic literature search was performed using EMBASE, Medline, the Cochrane library, and Google Scholar. Meta-analyses were performed using both fixed-effect and random-effect models. A cumulative meta-analysis was performed to track the accumulation of evidence. The power that a new trial of specified samples would give to the present meta-analysis was estimated with simulation-based sample size calculation. Patients who underwent laparoscopic distal pancreatectomy (LDP) had significantly smaller tumours [mean difference (MD) = -0.49 (-0.83 to -0.14), p = 0.005], less estimated blood loss [MD = -157.27 (-281.63 to -32.91), p = 0.01], and shorter average hospital stay by two days [MD = -2.35 (-3.1 to -1.59), p < .001] than those who underwent ODP. No significant differences in feasibility, effectiveness, and safety were noted. Cumulative meta-analysis demonstrated that the results were not dominated by a particular study. A new trial with 350 patients in each arm will give a maximum power of 48% to the present meta-analysis. LDP for pancreatic adenocarcinoma provides similar clinic...Continue Reading

References

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Citations

Nov 27, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Ryan J EllisRyan P Merkow
Jun 4, 2020·Annals of Gastroenterological Surgery·Nepal KovidJai Young Cho
Sep 6, 2020·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Yunxiao LyuLiang Chen
Dec 18, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Airazat M KazaryanBjørn Edwin
May 14, 2019·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Paschalis GavriilidisRobert P Sutcliffe

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