Retrospective Comparative Study Of Laparoscopic Pancreaticoduodenectomy And Open Pancreaticoduodenectomy In The Early Stage Of Learning

Objective:Retrospective comparative analysis of laparoscopic pancreaticoduodenectomy(LPD)and concurrent laparoscopic pancreaticoduodenectomy(OPD)in the initial study of laparoscopic pancreaticoduodenal Whether the resection(LPD)can achieve or exceed the therapeutic effect of the open pancreaticoduodenectomy(OPD)in the same period,and whether the LPD is suitable for the development of the country.Methods:Retrospective analysis of all data from 48 patients who underwent pancreaticoduodenectomy(PD)in the first and second clinical hospitals of the First and Second Clinical Hospital of Shanxi Medical University from July 2016 to March 2019,among which Thirty-six patients in the OPD group and 12 patients in the LPD group were compared.The preoperative basic information such as age,sex ratio,comorbidities,and initial symptoms were analyzed.Alanine aminotransferase,aspartate aminotransferase,total bilirubin,Preoperative test indicators such as direct bilirubin,hemoglobin concentration,albumin,glycoprotein antigen 199(pancreas),carcinoembryonic antigen,intraoperative blood loss,duration of surgery and blood transfusion rate,as well as ICU occupancy rate,ICU time Postoperative anal exhaust time,postoperative complications,secondary surgery,length of hospital stay,hospitalization expenses,etc.Results:There were no significant differences in age,sex ratio,comorbidities,and initial symptoms between the LPD group and the OPD group.There were no significant differences in preoperative test indicators such as alanine aminotransferase,aspartateaminotransferase,total bilirubin,direct bilirubin,sugar chain antigen 199(pancreas),and carcinoembryonic antigen.The length of operation in the LPD group was significantly longer than that in the OPD group [(607.9±124.2)min vs(327.5±82.2)min,p<0.01].The difference between the two groups was statistically significant.There was no significant difference in intraoperative blood loss between the two groups [(451.4±213.3)ml vs(329.2±381.1)ml,p=0.17].There was no significant difference in intraoperative blood transfusion rates between the two groups [50%(n=6).)vs 58%(n=21),p=0.614].There were no significant differences in the ICU occupancy rate,the first postoperative anal exhaust time,the second operation,the length of hospital stay,and the hospitalization cost in the LPD group and the OPD group,but the postoperative concurrency in the LPD group.The incidence of symptoms was more than that of the OPD group.There was a statistical difference between the two groups [p<0.01].The ICU stay in the LPD group was also longer than that in the OPD group [(3.5±2.0)d vs(1.5±2.6)d).,p <0.05],the difference between the two groups was statistically significant.Conclusion:This study compared the data of 36 cases of OPD and 12 cases of LPD in the first and second clinical hospitals of Shanxi Medical University.The analysis showed that LPD can successfully complete the resection of the operation in the early stage of the learning curve.Reconstruction requirements,but the advantages of minimally invasive are not obvious.In the operation time,LPD had a significant disadvantage.The postoperative ICU stay was longer than the OPD group,but the difference in overall hospital stay and hospitalization costs was not statistically significant.The incidence of postoperative complications in the LPD group was higher than in the OPD group.Before LPD is launched,it is necessary to fully prepare and shorten the early period of the learning curve.Only the early stage of LPD is shortened,so that more doctors and patients can accept this operation mode.LPD can be better promoted and applied.