Comparison of Clinical Curative Effect between Laparoscopic Pancreaticoduodenectomy and Open Pancreaticoduodenectomy on Terminal Bile Duct Carcinoma / 医学研究杂志

ABSTRACT

Objective To compare the clinical curative effect between laparoscopic pancreaticoduodenectomy (LPD) and open pancreaticoduodenectomy (OPD) in treatment of terminal bile duct carcinoma.Methods Clincal data of 40 patients with advanced terminal bile duct carcinoma who underwent pancreaticoduodenectomy in our hospital from March 2008 to March 2013 were collected,of which 12 patients were in LPD group and 28 patients in OPD group.Results Hospitalization expense and operative time of patients were in LPD group were both more or longer than those of OPD group (P ＜ 0.05),but haemorrhage,pulling out the drainage tube time,pulling out the stomach tube time,active time post-operation,aeration time,absolute resting on bed time,and hospitalization time in LPD group were lower or shorter than those of OPD group (P ＜ 0.05).There were 15 patients suffered with postoperative complication,including 5 patients in LPD group and 10 patients in OPD group,and there was no significant difference between the two groups in total incidence of postoperative complication (P ＞ 0.05).In the specific postoperative complication,the incidences of biliary fistula of LPD group were higher than those of OPD group (P ＜ 0.05),but incidences of pancreatic fistula,systemic infection,pulmonary infection,incision infection,and delayed gastric emptying between two groups were no significant difference (P ＞ 0.05).All patients were followed up for 1-36 months with the median time of 27 months.During the follow-up periods,in LPD group,8 patients suffered with recurrence,6 patients suffered with tumor metastasis,and 8 patients died;in OPD group,18 patients suffered with recurrence,13 patients suffered with tumor metastasis,and 18 patients died.There were no significant difference between two groups in the recurrence rate,metastasis rate,and mortality (P ＞ 0.05).Conclusion According to the results of the current study,for patients with common bile duct cancer,LPD group was superior to OPD group in the postoperative recovery.But compared with OPD group,it had no obvious advantage in reducing biliary fistula,pancreatic fistula,infection,delayed gastric emptying,and so on,and it also had no obvious advantage in improving the long-term survival situation.However,due to the relatively small sample size of the two groups,the results of this study may lead to some bias,the curative effect of two kinds of surgical comparison still need more clinical research to further explore.