Clinical Comparative Study Of Laparoscopic Versus Open Pancreaticoduodenectomy

Objective:To study the feasibility and safety of laparoscopic pancreatic oduodenectomy (LPD). Merhod:Using statistical methods compare the efficacy of laparoscopic pancreatic coduodenectomy by 26 cases versus open pancreaticoduodenectomy by 26 cases in our hospital from February 2002 to December 2009.The comparative aspects include operstive time,blood loss,tatal drainage of three days,intestinal function recovery time,number of postoperative analgesics,incidence of postoperative complications,the reduced number of bilirubin,postoperative hospital stay,hospital costs. Results:26 cases of LPD were successful in the laparoscopic group,without conversion to open surery. In the open group 26 cases of PD were successful. Compared with open surgery, laparoscopic surgery group has longer operation time [(489.46±75.554) min,(397.50±62.428)min, P=0.000]; intraoperative mean blood loss was no significant [(613.64±410.627)ml,(660.80±327.744) ml,P=0.664];the mean total three days'drainage after operation was more [(1102.83±545.787)ml,(612.00±482.642)ml,P=0.002]; Postoperative intestinal function recovery time was no difference[(4.40±1.323)d [(1102.83±545.787)ml,(612.00±482.642)ml,P=0.002]; Postoperative intestinal function recovery time was no difference[(4.40±1.323)d (4.85±1.515)d,P=0.269]; mean postoperative analgesics were less [(2.32±1.749)times,(3.73±3.001)times,P=0.047]; there was no difference in postoperative complications(P=0.781),12 patients(46.15%)had compliacations after LPD,including 2cases of death,3cases of pancreatic fistula,13 patients (50%)had compliacations after PD,including 7cases of pancreatic fistula.The mean postoperative hospital stay was no significant [(27.00±10.529) d. (24.79±10.754) d, P=0.476]; total hospital costs was no significant [￥(63873.23±19671.288).￥(55180.31±25634.147), P=0.182].Conclusion: 1 Laparoscopic pancreaticoduodenectomy has some advantages of minimally invasive, and it is a safe, practical surgery.2 The method of anastomosising Pancreaticojejunal used in Laparoscopic group feasible, it is possible to replace the traditional method and be widely used.3 Long-term effect of laparoscopic pancreaticoduodenectomy needs further clinical study.