Comparison of the perioperative outcomes of 2 different types of minimally invasive pancreaticoduodenectomy in elderly patients aged ≥65 years
10.3781/j.issn.1000-7431.2023.2305-0224
- VernacularTitle:65岁及以上老年患者行2种不同微创胰十二指肠切除术围手术期结果的比较
- Author:
Yufeng REN
1
;
Qitao JIANG
;
Yiping MOU
;
Weiwei JIN
;
Yucheng ZHOU
;
Tao XIA
;
Chao LU
;
Yuanyu WANG
;
Qicong ZHU
Author Information
1. 浙江省人民医院胃肠胰外科,浙江省胃肠病学重点实验室,浙江 杭州 310014
- Keywords:
Pancreaticoduodenectomy;
Elderly patient;
Robotic surgery;
Laparoscopic operation;
Complications
- From:
Tumor
2023;43(6):516-524
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To compare the perioperative outcomes between robotic pancreaticoduodenectomy(RPD)and laparoscopic pancreaticoduode-nectomy(LPD)in patients aged ≥65 years. Methods:The clinical data of 130 patients aged ≥65 years who received minimally invasive pancreaticoduodenectomy(MIPD)at Department of Gastrointestinal and Pancreatic Surgery,Zhejiang Provincial People's Hospital from January 2019 to December 2022 were retrospectively analyzed.The patients were divided into the RPD group(n=66)and the LPD group(n=64)according to the operation method,and the perioperative clinical data were compared between the 2 groups. Results:Compared with the LPD group,the average age of patients in the RPD group was higher than that of the LPD group[(71.95±4.73)years vs(70.39±3.9)years,P＜0.05];the RPD group had more patients with diabetes(39.4％vs 18.8％,P＜0.05)and cardiopulmonary diseases(37.9％vs 17.2％,P＜0.05);the RPD group had shorter operation time[(272.91± 68.38)min vs(362.81±78.24)min,P＜0.05]and less intraoperative blood loss[median(range):1 00 mL(50-200 mL)vs 1 50 mL(1 00-200 mL),P＜0.05)];the RPD group had higher incidence of chylous fistula(1 2.1％vs 1.6％,P＜0.05)but lower incidence of surgical morbidity(37.9％vs 46.9％),serious complications(19.7％vs 34.4％),postoperative pancreatic fistula(12.1％vs 17.2％),biliary fistula(3.0％vs 3.1％),abdominal infection(10.6％vs 14.1％),postoperative bleeding(4.5％vs 4.5％),and postoperative cardiopulmonary complications(1 2.1％vs 20.3％)with no statistically significant difference(P＞0.05);the RPD group waited shorter time before restarting diet[(3.97±1.59)d vs(5.34±2.56)d,P＜0.05]. Conclusion:MIPD is safe and feasible in patients aged ≥65 years.The incidence of perioperative complications is similar between the 2 groups.Compared with LPD,RPD has shorter operation time,less intraoperative blood loss,and shorter duration before restarting diet after operation,which has certain clinical advantages.
