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| 1 | A matched-pair analysis of laparoscopic versus open pancreaticoduodenectomy: oncological outcomes using Leeds Pathology Protocol显示文摘BACKGROUND: Laparoscopic pancreaticoduodenectomy(LPD)is a safe procedure. Oncological safety of LPD is still a matter for debate. This study aimed to compare the oncological outcomes,in terms of adequacy of resection and recurrence rate following LPD and open pancreaticoduodenectomy(OPD).METHODS: Between November 2005 and April 2009, 12LPDs(9 ampullary and 3 distal common bile duct tumors)were performed. A cohort of 12 OPDs were matched for age,gender, body mass index(BMI) and American Society of Anesthesiologists(ASA) score and tumor site.RESULTS: Mean tumor size LPD vs OPD(19.8 vs 19.2 mm,P=0.870). R0 resection was achieved in 9 LPD vs 8 OPD(P=1.000). The mean number of metastatic lymph nodes and total number resected for LPD vs OPD were 1.1 vs 2.1(P=0.140)and 20.7 vs 18.5(P=0.534) respectively. Clavien complications grade I/II(5 vs 8), III/IV(2 vs 6) and pancreatic leak(2 vs 1)were statistically not significant(LPD vs OPD). The mean high dependency unit(HDU) stay was longer in OPD(3.7 vs 1.4 days,P<0.001). There were 2 recurrences each in LPD and OPD(logrank,P=0.983). Overall mortality for LPD vs OPD was 3 vs 6(log-rank, P=0.283) and recurrence-related mortality was 2 vs 1.There was one death within 30 days in the OPD group secondary to severe sepsis and none in the LPD group.CONCLUSIONS: Compared to open procedure, LPD achieved a similar rate of R0 resection, lymph node harvest and longterm recurrence for tumors less than 2 cm. Though technically challenging, LPD is safe and does not compromise oncological outcome. | Abdul R Hakeem Caroline S Verbeke Alison Cairns Amer Aldouri Andrew M Smith Krishna V Menon | 2014 | Hepatobiliary & Pancreatic Diseases International2014,13,4: | 24 |
| 2 | The bone marrow functionally contributes to liver fibrosis显示文摘 | Russo F P Alison M R Bigger B W | 2006 | Gastroenterology2006,130,6: | 1 |
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