Minimal-invasive approach to pancreatoduodenectomy is associated with lower early postoperative morbidity

Zhobin Moghadamyeghaneh, Danny Sleeman, Lygia Stewart

Research output: Contribution to journalArticle

Abstract

Objectives: We aim to investigate the impact of the operation time for pancreatoduodenectomy (PD) in different surgical approaches. Methods: The NSQIP database was used to examine the clinical data of patients underwent PD during 2014–2016. Results: We sampled a total of 6151 patients who underwent elective PD. Of these, 452(7.3%) had minimally invasive approaches to PD. Minimally invasive approaches (MIS) to PD was associated with a significant decrease in morbidity of patients (AOR: 0.67, P < 0.01). Following risk adjustment for morbidity predictors, operation length was statistically associated with post-operative morbidity (AOR: 1.002, P < 0.01). Although MIS procedures were significantly longer operations compared to open procedures (443 min vs. 371 min, CI: 53–82 min, P < 0.01), MIS approaches were associated with significantly decreased morbidity in low stage tumors (stage zero-II) (51.3% vs. 56.2%, AOR: 0.72, P = 0.03) and advanced stage disease (stage III-IV) (50% vs. 60.3%, AOR: 0.38, P = 0.04). Conclusion: Minimally invasive approaches to PD were associated with decreased post-operative morbidity, even though they were associated with longer operative times. Operation length also significantly correlated with postoperative morbidity.

Original languageEnglish (US)
Pages (from-to)718-724
Number of pages7
JournalAmerican journal of surgery
Volume217
Issue number4
DOIs
StatePublished - Apr 1 2019

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Pancreaticoduodenectomy
Morbidity
Risk Adjustment
Operative Time
Databases
Neoplasms

Keywords

  • Laparoscopic surgery
  • Minimally invasive surgery
  • Operation time
  • Pancreatoduodenectomy
  • Robotic surgery
  • Whipple

ASJC Scopus subject areas

  • Surgery

Cite this

Minimal-invasive approach to pancreatoduodenectomy is associated with lower early postoperative morbidity. / Moghadamyeghaneh, Zhobin; Sleeman, Danny; Stewart, Lygia.

In: American journal of surgery, Vol. 217, No. 4, 01.04.2019, p. 718-724.

Research output: Contribution to journalArticle

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abstract = "Objectives: We aim to investigate the impact of the operation time for pancreatoduodenectomy (PD) in different surgical approaches. Methods: The NSQIP database was used to examine the clinical data of patients underwent PD during 2014–2016. Results: We sampled a total of 6151 patients who underwent elective PD. Of these, 452(7.3{\%}) had minimally invasive approaches to PD. Minimally invasive approaches (MIS) to PD was associated with a significant decrease in morbidity of patients (AOR: 0.67, P < 0.01). Following risk adjustment for morbidity predictors, operation length was statistically associated with post-operative morbidity (AOR: 1.002, P < 0.01). Although MIS procedures were significantly longer operations compared to open procedures (443 min vs. 371 min, CI: 53–82 min, P < 0.01), MIS approaches were associated with significantly decreased morbidity in low stage tumors (stage zero-II) (51.3{\%} vs. 56.2{\%}, AOR: 0.72, P = 0.03) and advanced stage disease (stage III-IV) (50{\%} vs. 60.3{\%}, AOR: 0.38, P = 0.04). Conclusion: Minimally invasive approaches to PD were associated with decreased post-operative morbidity, even though they were associated with longer operative times. Operation length also significantly correlated with postoperative morbidity.",
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