1.Evaluation of perioperative indicators of open, laparoscopic, and robotic pancreaticoduodenectomy based on propensity score matching
Kaixuan ZHANG ; Kunlun CHEN ; Yuan HE ; Enchi LIU
Chinese Journal of Hepatobiliary Surgery 2024;30(12):928-934
Objective:To Compare perioperative indicators of open pancreaticoduodenectomy (OPD), laparoscopic pancreaticoduodenectomy (LPD), and robotic pancreaticoduodenectomy (RPD) using propensity score matching (PSM).Methods:A retrospective analysis of the clinical data of 167 patients with periampullary lesions who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Zhengzhou University from January 2018 to March 2022. The cohort included 100 males and 67 females, with age of (58.92±11.47) years. Based on the surgical approach, patients were divided into three groups: OPD group ( n=67), LPD group ( n=58), and RPD group ( n=42). Clinical data such as gender, age, operation time, and postoperative complications were collected. PSM was employed to eliminate confounding factors and evaluate the effect of different surgical methods on perioperative outcomes. Results:After PSM, there were 42 cases in the OPD group, 29 cases in the LPD group, and 25 cases in the RPD group. The baseline characteristics of the three groups were compared, and no statistically significant differences were found (all P>0.05). The operation time in the LPD group was longer than that in the OPD group [6.0 (5.1, 7.1) h vs. 4.8 (4.1, 5.3) h, Z=221.50, P<0.001] and the RPD group [6.0 (5.1, 7.1) h vs. 5.3 (4.5, 6.0) h, Z=222.00, P=0.015], with statistically significant differences. The intraoperative blood transfusion volume in the OPD group was higher than that in the RPD group [0 (0, 600.0) ml vs. 0 ml], with a statistically significant difference ( Z=368.50, P=0.011). The length of hospital stay in the OPD group was longer than that in the LPD group [15.5(12.8, 22.3) d vs. 11.0(9.5, 16.0) d, Z=354.50, P=0.003] and the RPD group [15.5(12.8, 22.3) d vs. 11.0(8.5, 15.5) d, Z=289.00, P=0.002], with statistically significant differences. The duration of intravenous analgesic use in the OPD group was longer than that in the RPD group [1.5(0, 3.0) d vs. 0(0, 1.0) d], with a statistically significant difference ( Z=310.50, P=0.004). Additionally, the time to gastric tube removal after surgery in the OPD group was longer than that in the LPD group [3.0(2.0, 4.0) d vs. 2.0(2.0, 3.0) d, Z=392.50, P=0.009] and the RPD group [3.0(2.0, 4.0) d vs. 2.0(1.0, 3.5) d, Z=297.50, P=0.003], with statistically significant differences. There were no statistically significant differences in postoperative complications among the three groups. Conclusion:Compared with LPD, RPD had a shorter operation time; compared with OPD, both LPD and RPD were able to reduce hospital stay and intravenous analgesic use, and decrease intraoperative blood transfusion.
2.Evaluation of perioperative indicators of open, laparoscopic, and robotic pancreaticoduodenectomy based on propensity score matching
Kaixuan ZHANG ; Kunlun CHEN ; Yuan HE ; Enchi LIU
Chinese Journal of Hepatobiliary Surgery 2024;30(12):928-934
Objective:To Compare perioperative indicators of open pancreaticoduodenectomy (OPD), laparoscopic pancreaticoduodenectomy (LPD), and robotic pancreaticoduodenectomy (RPD) using propensity score matching (PSM).Methods:A retrospective analysis of the clinical data of 167 patients with periampullary lesions who underwent pancreaticoduodenectomy at the First Affiliated Hospital of Zhengzhou University from January 2018 to March 2022. The cohort included 100 males and 67 females, with age of (58.92±11.47) years. Based on the surgical approach, patients were divided into three groups: OPD group ( n=67), LPD group ( n=58), and RPD group ( n=42). Clinical data such as gender, age, operation time, and postoperative complications were collected. PSM was employed to eliminate confounding factors and evaluate the effect of different surgical methods on perioperative outcomes. Results:After PSM, there were 42 cases in the OPD group, 29 cases in the LPD group, and 25 cases in the RPD group. The baseline characteristics of the three groups were compared, and no statistically significant differences were found (all P>0.05). The operation time in the LPD group was longer than that in the OPD group [6.0 (5.1, 7.1) h vs. 4.8 (4.1, 5.3) h, Z=221.50, P<0.001] and the RPD group [6.0 (5.1, 7.1) h vs. 5.3 (4.5, 6.0) h, Z=222.00, P=0.015], with statistically significant differences. The intraoperative blood transfusion volume in the OPD group was higher than that in the RPD group [0 (0, 600.0) ml vs. 0 ml], with a statistically significant difference ( Z=368.50, P=0.011). The length of hospital stay in the OPD group was longer than that in the LPD group [15.5(12.8, 22.3) d vs. 11.0(9.5, 16.0) d, Z=354.50, P=0.003] and the RPD group [15.5(12.8, 22.3) d vs. 11.0(8.5, 15.5) d, Z=289.00, P=0.002], with statistically significant differences. The duration of intravenous analgesic use in the OPD group was longer than that in the RPD group [1.5(0, 3.0) d vs. 0(0, 1.0) d], with a statistically significant difference ( Z=310.50, P=0.004). Additionally, the time to gastric tube removal after surgery in the OPD group was longer than that in the LPD group [3.0(2.0, 4.0) d vs. 2.0(2.0, 3.0) d, Z=392.50, P=0.009] and the RPD group [3.0(2.0, 4.0) d vs. 2.0(1.0, 3.5) d, Z=297.50, P=0.003], with statistically significant differences. There were no statistically significant differences in postoperative complications among the three groups. Conclusion:Compared with LPD, RPD had a shorter operation time; compared with OPD, both LPD and RPD were able to reduce hospital stay and intravenous analgesic use, and decrease intraoperative blood transfusion.
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