The short- and long-term outcomes of laparoscopic pancreaticoduodenectomy combining with different type of mesentericoportal vein resection and reconstruction for pancreatic head adenocarcinoma: a Chinese multicenter retrospective cohort study

作者全名："Ouyang, Guoqing; Zhong, Xiaosheng; Cai, Zhiwei; Liu, Jianhua; Zheng, Shangyou; Hong, Defei; Yin, Xinmin; Yu, Jian; Bai, Xueli; Liu, Yahui; Liu, Jun; Huang, Xiaobing; Xiong, Yong; Xu, Jie; Cai, Yunqiang; Jiang, Zhongyi; Chen, Rufu; Peng, Bing"

作者地址："[Ouyang, Guoqing; Cai, Yunqiang; Peng, Bing] Sichuan Univ, West China Hosp, Dept Pancreat Surg, 37 Guo Xue Alley, Chengdu 610041, Sichuan, Peoples R China; [Zhong, Xiaosheng] Guangzhou Univ Chinese Med, Dept Pancreat Surg, Affiliated Hosp 2, Guangzhou, Guangdong, Peoples R China; [Cai, Zhiwei; Jiang, Zhongyi] Fudan Univ, Dept Surg, Huadong Hosp, Shanghai, Peoples R China; [Liu, Jianhua] Hebei Med Univ, Dept Hepatopancreato Biliary Surg, Hosp 2, Shijiazhuang, Hebei, Peoples R China; [Zheng, Shangyou; Chen, Rufu] Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Pancreas Ctr, Dept Gen Surg, Guangzhou, Guangdong, Peoples R China; [Zheng, Shangyou; Chen, Rufu] Southern Med Univ, Sch Clin Med 2, Guangzhou, Guangdong, Peoples R China; [Hong, Defei] Zhejiang Univ, Sir Run Run Shaw Hosp, Dept Gen Surg, Med Sch, Hangzhou, Zhejiang, Peoples R China; [Yin, Xinmin] Peoples Hosp Hunan Prov, Dept Hepatobiliary Surg, Changsha, Hunan, Peoples R China; [Yu, Jian; Bai, Xueli] Zhejiang Univ, Affiliated Hosp 1, Dept Hepatobiliary & Pancreat Surg, Sch Med, Hangzhou, Zhejiang, Peoples R China; [Liu, Yahui] First Hosp Jilin Univ, Dept Hepatobiliary & Pancreat Surg, Changchun, Jilin, Peoples R China; [Liu, Jun] Shandong Univ, Shandong Prov Hosp, Dept Live Transplantat & Hepatobiliary Surg, Jinan, Shandong, Peoples R China; [Liu, Jun] Shandong First Med Univ, Dept Live Transplantat & Hepatobiliary Surg, Shandong Prov Hosp, Jinan, Shandong, Peoples R China; [Huang, Xiaobing] Second Affiliated Army Med Univ, Dept Hepatobiliary Surg, Chongqing, Peoples R China; [Xiong, Yong] Panzhihua Cent Hosp, Dept Hepatobiliary Surg, Panzhihua, Sichuan, Peoples R China; [Xu, Jie] Chongqing Med Univ, Dept Hepatobiliary Surg, Affiliated Hosp 2, Chongqing, Peoples R China"

通信作者："Cai, YQ; Peng, B (通讯作者)，Sichuan Univ, West China Hosp, Dept Pancreat Surg, 37 Guo Xue Alley, Chengdu 610041, Sichuan, Peoples R China.; Jiang, ZY (通讯作者)，Fudan Univ, Dept Surg, Huadong Hosp, Shanghai, Peoples R China.; Chen, RF (通讯作者)，Guangdong Acad Med Sci, Guangdong Prov Peoples Hosp, Dept Pancreas Ctr, Dept Gen Surg, Guangzhou, Guangdong, Peoples R China.; Chen, RF (通讯作者)，Southern Med Univ, Sch Clin Med 2, Guangzhou, Guangdong, Peoples R China."

来源：SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000940436700005

JCR分区：Q2

影响因子：2.4

年份：2023

卷号：　

期号：　

开始页：　

结束页：　

文献类型：Article; Early Access

关键词：Laparoscopic pancreaticoduodenectomy; Mesentericoportal vein reconstruction; Morbidity; Mortality; Progress-free survival; Overall survival

摘要："BackgroundThe results of laparoscopic pancreaticoduodenectomy combining with mesentericoportal vein resection and reconstruction (LPD-MPVRs) for pancreatic head adenocarcinoma are rarely reported. The aim of present study was to explore the short- and long-term outcomes of different type of LPD-MPVRs.MethodsPatients who underwent LPD-MPVRs in 14 Chinese high-volume pancreatic centers between June 2014 and December 2020 were selected and compared.ResultsIn total, 142 patients were included and were divided into primary closure (n = 56), end-end anastomosis (n = 43), or interposition graft (n = 43). Median overall survival (OS) and median progress-free survival (PFS) between primary closure and end-end anastomosis had no difference (both P > 0.05). As compared to primary closure and end-end anastomosis, interposition graft had the worst median OS (12 months versus 19 months versus 17 months, P = 0.001) and the worst median PFS (6 months versus 15 months versus 12 months, P < 0.000). As compared to primary closure, interposition graft had almost double risk in major morbidity (16.3 percent versus 8.9 percent) and about triple risk (10 percent versus 3.6 percent) in 90-day mortality, while End-end anastomosis had only one fourth major morbidity (2.3 percent versus 8.9 percent). Multivariate analysis revealed postoperation hospital stay, American Society of Anesthesiologists (ASA) score, number of positive lymph nodes had negative impact on OS, while R0, R1 surgical margin had protective effect on OS. Postoperative hospital stay had negative impact on PFS, while primary closure, end-end anastomosis, short-term vascular patency, and short-term vascular stenosis positively related to PFS.ConclusionsIn LPD-MPVRs, interposition graft had the worst OS, the worst PFS, the highest rate of major morbidity, and the highest rate of 90-day mortality. While there were no differences in OS and PFS between primary closure and end-end anastomosis."

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