The Inflammatory Response and Long-Term Outcomes Between Open and Laparoscopic Pancreatoduodenectomy:A Propensity-Matched Single-Institution Study.
Jiaping WangShuang YuShun LiuXue LiangShupeng WangLin LiPublished in: Journal of laparoendoscopic & advanced surgical techniques. Part A (2024)
Background: In recent years, although laparoscopic pancreatoduodenectomy (LPD) has experienced rapid development both domestically and internationally, however, there are still varying opinions toward LPD. Methods: From January 2020 to July 2022, the data were collected. We compared the inflammatory response at various postoperative time points and evaluated long-term outcomes between the two groups. Results: In the early stage, the LPD group exhibited lower values of white blood cells, C-reactive protein, neutrophils, and platelets after surgery compared with open pancreatoduodenectomy (OPD) ( P all<0.05). However, no statistically significant differences were observed in terms of procalcitonin, neutrophil-to-lymphocyte ratio, and platelet-to-lymphocyte ratio. Before propensity score matching, no statistical significance was observed between two groups, whether in terms of disease-free survival (DFS) ( P = .406) or overall survival (OS) ( P = .851). However, to further control for confounding factors, propensity score matching was used. The analysis revealed that DFS still showed no significant difference ( P = .928), but, in the term of OS, a statistical significance was observed between the two groups. Conclusion: LPD demonstrates a comparable long-term outcomes to OPD and even slightly superior OS. Moreover, the LPD group exhibits a lower inflammatory response during early postoperative period.
Keyphrases
- inflammatory response
- free survival
- lipopolysaccharide induced
- early stage
- lps induced
- toll like receptor
- robot assisted
- minimally invasive
- patients undergoing
- induced apoptosis
- cell cycle arrest
- electronic health record
- squamous cell carcinoma
- single cell
- immune response
- signaling pathway
- data analysis
- rectal cancer
- sensitive detection
- loop mediated isothermal amplification