| Objective: To assess and evaluate the feasibility and advantages of laparoscopic pancreaticoduodenectomy(LPD)compared with open pancreasticoduodenectomy(OPD)Methods: Pub Med,Web of Science and Cochrane Central Register of Controlled Trials(CENTRAL)were searched on LPD versus OPD before October2019.In this study,5-year survival rate,R0 resection rate,number of lymph node dissection,postoperative pancreatic fistula incidence,intraoperative blood loss,postoperative bleeding and length of hospital stay were used as evaluation indicators to measure the safety and feasibility of laparoscopic pancreaticoduodenectomy.Results: A total of 13809 patients from 8 studies were included in this meta-analysis.There was no significant difference in 5-year survival rate between the two surgical methods(HR:0.97,95%CI: 0.82--1.15,P=0.76).Compared with OPD group,there were no statistically significant differences in R0 resection rate(OR: 1.16,95%CI: 0.85-1.57,P> 0.05),incidence of postoperative pancreatic fistula(POPFs)(OR:1.07,95%ci :0.68-1.68,p=0.77)OR postoperative hemorrhage(OR:1.74,95%ci:0.96-3.71,p=0.07)in LPD group.The number of lymph node dissection in LPD group(WMD:1.84,95%CI:0.95-2.72,P <0.05),length of hospital stay(WMD:-2.45,95%CI:-3.33--1.56,P <0.05),and estimated blood loss(WMD:-374.30,95%CI:-513.06--235.54,P <0.05)were better than those in OPD group.Conclusion: Compared with OPD group,LPD group showed no significant difference in postoperative R0 resection rate and 5-year survival rate andwas superior to OPD group in terms of the number of lymph nodes dissected,length of hospital stays and intraoperative blood loss. |
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