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The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis

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作者：
Bas A. Uijterwijk[1,2] * ; Meidai Kasai[3] ; Daniel H. L. Lemmers[1,2] ; Palanivelu Chinnusamy[4] ; Jony van Hilst[2,5] ; Benedetto Ielpo[6] ; Kongyuan Wei[7] ; Ki Byung Song[8] ; Song C. Kim[8] ; Sjors Klompmaker[2] ; Jin‑Young Jang[9] ; Kelly M. Herremans[10] ; Lapo Bencini[11] ; Andrea Coratti[12] ; Michele Mazzola[13] ; Krishna V. Menon[14] ; Brian K. P. Goh[15] ; Renyi Qin[16] ; Marc G. Besselink[2] ; Mohammed Abu Hilal[1] ;
单位： [1]Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy [2]Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands [3]Department of Surgery, Meiwa Hospital, Hyogo, Japan [4]Department of Surgical Gastroenterology and Hepatopancreatobiliary Surgery, GEM Hospital and Research Center, Ramanathapuram, Coimbatore, Tamil Nadu, India [5]Department of Surgery, OLVG, Amsterdam, the Netherlands [6]Hepatobiliary and Pancreatic Surgery Unit, Hospital del Mar. Universitat Pompeu Fabra, Barcelona, Spain [7]Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany [8]Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea [9]Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, South Korea [10]Division of Surgical Oncology, General Surgery, University of Florida, Gainesville, USA [11]Department of Surgery, Careggi University Hospital, Florence, Italy [12]Department of Surgery, Misericordia Hospital of Grosseto, Grosseto, Italy [13]Division of Oncologic and Mini-Invasive General Surgery, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy [14]Department of Liver Transplant and HPB Unit, King’s College Hospital, London, UK [15]Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore, Singapore [16]Department of Biliary-Pancreatic Surgery, Afliated Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
出处：
DOI： 10.1007/s00423-023-03047-4
ISSN：

关键词： Minimally invasive surgery  Minimally invasive pancreatoduodenectomy  Ampulla of Vater carcinoma  Duodenal adenocarcinoma  Distal cholangiocarcinoma  Individual patient data meta-analysis

摘要：
Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC).A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma) (01/2015-12/2021). Individual patient data were required from all identified studies. Primary outcomes were (90-day) mortality, and major morbidity (Clavien-Dindo 3a-5). Secondary outcomes were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), blood-loss, length of hospital stay (LOS), and overall survival (OS).Overall, 16 studies with 1949 patients were included, combining 928 patients with ampullary, 526 with distal cholangio, and 461 with duodenal cancer. In total, 902 (46.3%) patients underwent MIPD, and 1047 (53.7%) patients underwent OPD. The rates of 90-day mortality, major morbidity, POPF, DGE, PPH, blood-loss, and length of hospital stay did not differ between MIPD and OPD. Operation time was 67 min longer in the MIPD group (P = 0.009). A decrease in DFS for ampullary (HR 2.27, P = 0.019) and distal cholangio (HR 1.84, P = 0.025) cancer, as well as a decrease in OS for distal cholangio (HR 1.71, P = 0.045) and duodenal cancer (HR 4.59, P < 0.001) was found in the MIPD group.This individual patient data meta-analysis of MIPD versus OPD in patients with NPPC suggests that MIPD is not inferior in terms of short-term morbidity and mortality. Several major limitations in long-term data highlight a research gap that should be studied in prospective maintained international registries or randomized studies for ampullary, distal cholangio, and duodenum cancer separately.PROSPERO (CRD42021277495) on the 25th of October 2021.© 2023. The Author(s).

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外文
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出版当年[2022]版：
大类 | 3 区 医学
小类 | 3 区 外科
最新[2025]版：
大类 | 3 区 医学
小类 | 3 区 外科
JCR分区：
出版当年[2021]版：
Q2 SURGERY
最新[2023]版：
Q2 SURGERY

影响因子： 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

第一作者：
第一作者单位： [1]Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy [2]Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
通讯作者：
通讯机构： [1]Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero, Brescia, Italy [2]Department of Surgery, Amsterdam UMC, Location University of Amsterdam, Amsterdam, the Netherlands
推荐引用方式(GB/T 7714)：
Bas A. Uijterwijk,Meidai Kasai,Daniel H. L. Lemmers,et al.The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis[J].LANGENBECKS ARCHIVES OF SURGERY.2023,408(1):311.doi:10.1007/s00423-023-03047-4.
APA：
Bas A. Uijterwijk,Meidai Kasai,Daniel H. L. Lemmers,Palanivelu Chinnusamy,Jony van Hilst...&Mohammed Abu Hilal.(2023).The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis.LANGENBECKS ARCHIVES OF SURGERY,408,(1)
MLA：
Bas A. Uijterwijk,et al."The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer: a systematic review and individual patient data meta-analysis".LANGENBECKS ARCHIVES OF SURGERY 408..1(2023):311

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