Oncological resection and perioperative outcomes of robotic, laparoscopic and open pancreatoduodenectomy for ampullary adenocarcinoma: a propensity score matched international multicenter cohort study

被引：0

作者：

Uijterwijk, Bas A. ^{[2
,3
]}

Moekotte, Alma ^{[2
,3
]}

Boggi, Ugo ^{[4
]}

Mazzola, Michele ^{[5
]}

Koerkamp, Bas Groot ^{[6
]}

Valle, Raffaele Dalle ^{[7
]}

Koek, Sharnice ^{[8
]}

Bolm, Louisa ^{[9
]}

Mazzotta, Alessandro ^{[10
]}

Luyer, Misha ^{[11
]}

Goh, Brian K. P. ^{[12
]}

Munoz, Miguel A. Suarez ^{[13
]}

Bjornsson, Bergthor ^{[14
,15
]}

Kazemier, Geert ^{[16
]}

Ielpo, Benedetto ^{[17
]}

Pessaux, Patrick ^{[18
]}

Kleeff, Jorg ^{[19
]}

Ghorbani, Poya ^{[20
]}

Mavroeidis, Vasileios K. ^{[21
,22
]}

Fusai, Giuseppe K. ^{[23
]}

Salvia, Roberto ^{[24
]}

Zerbi, Alessandro ^{[25
,38
]}

Roberts, Keith J. ^{[26
]}

Alseidi, Adnan ^{[27
]}

Al-Sarireh, Bilal ^{[28
]}

Serradilla-Martin, Mario ^{[29
]}

Vladimirov, Miljana ^{[30
,31
]}

Korkolis, Dimitris ^{[32
]}

Soonawalla, Zahir ^{[22
]}

Gruppo, Mario ^{[33
]}

Bouwense, Stefan A. W. ^{[34
]}

Vollmer, Charles M. ^{[35
]}

Behrman, Stephen W. ^{[36
]}

Christein, John D. ^{[37
]}

Besselink, Marc G. ^{[2
,3
]}

Abu Hilal, Mohammed ^{[1
]}

机构：

[1] Fdn Poliambulanza, Dept Surg, Brescia, Italy

[2] Amsterdam UMC, Dept Surg, Locat Vrije Univ, Amsterdam, Netherlands

[3] Canc Ctr Amsterdam, Amsterdam, Netherlands

[4] Pisa Univ Hosp, Dept Surg, Pisa, Italy

[5] ASST Grande Osped Metropolitano Niguarda, Div Oncol & Mini Invas Gen Surg, Milan, Italy

[6] Erasmus MC Canc Inst, Dept Surg, Rotterdam, Netherlands

[7] Univ Hosp Parma, Dept Surg, Parma, Italy

[8] Fiona Stanley Hosp, Dept Surg, Perth, Australia

[9] Univ Med Ctr Schleswig Holstein, Dept Surg, Campus Lubeck, Lubeck, Germany

[10] Inst Mutualiste Montsouris, Dept Digest Oncol & Metab Surg, Paris, France

[11] Catharina Hosp, Dept Surg, Eindhoven, Netherlands

[12] Duke Natl Univ Singapore, Singapore Gen Hosp, Dept Hepatopancreatobiliary & Transplant Surg, Singapore, Singapore

[13] Univ Hosp Virgen Victoria, Dept Surg, Malaga, Spain

[14] Linkoping Univ, Dept Surg Linkoping, Linkoping, Sweden

[15] Linkoping Univ, Dept Biomed & Clin Sci, Linkoping, Sweden

[16] Amsterdam UMC, Dept Surg, Locat VUmc, Amsterdam, Netherlands

[17] Hosp Mar, Dept Surg, Barcelona, Spain

[18] Nouvel Hop Civil NHC, Hepatobiliary & Pancreat Surg Unit, Strasbourg, France

[19] Martin Luther Univ Halle Wittenberg, Dept Surg, Halle, Saale, Germany

[20] Karolinska Inst, Karolinska Univ Hosp, Dept Clin Sci Intervent & Technol, Div Surg, Stockholm, Sweden

[21] Royal Marsden Hosp, Dept Acad Surg, London, England

[22] Oxford Univ Hosp NHS Fdn Trust, Dept Hepatobiliary & Pancreat Surg, Oxford, England

[23] Royal Free London NHS Fdn Trust, Dept Surg, London, England

[24] Univ Verona Hosp Trust, Pancreas Inst, Dept Gen & Pancreat Surg, Verona, Italy

[25] Humanitas Univ, Dept Biomed Sci, Pieve Emanuele, Italy

[26] Univ Birmingham, Fac Med, Birmingham, England

[27] Virginia Mason, Dept Surg, Seattle, WA USA

[28] Morriston Hosp, Dept Surg, Swansea, Wales

[29] Miguel Servet Univ Hosp, Dept Surg, Inst Invest Sanitaria Aragon, Zaragoza, Spain

[30] Paracelsus Med Univ Nurnberg, Dept Gen Surg, D-90419 Nurnberg, Germany

[31] Univ Bielefeld, Univ Hosp Lippe, Dept Abdominal Surg, Campus Detmold, Bielefeld, Germany

[32] Hellen Anticanc Hosp St Savvas, Dept Surg, Athens, Greece

[33] Veneto Inst Oncol IOV IRCCS, Unit Surg Oncol Digest Tract, Padua, Italy

[34] Maastricht Univ, Dept Surg, Med Ctr, Maastricht, Netherlands

[35] Univ Penn, Perelman Sch Med, Dept Surg, Philadelphia, PA USA

[36] Univ Tennessee, Hlth Sci Ctr, Dept Surg, Memphis, TN USA

[37] Univ Alabama Birmingham, Dept Surg, Sch Med, Birmingham, AL USA

[38] IRCCS Humanitas Res Hosp, Pancreat Surg, Rozzano, Italy

来源：

HPB | 2025年 / 27卷 / 03期

关键词：

PANCREATIC DUCTAL ADENOCARCINOMA; LONG-TERM; SURGERY; CLASSIFICATION; DEFINITION; RELEVANCE; SURVIVAL;

D O I：

10.1016/j.hpb.2024.11.013

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: Ampullary adenocarcinoma (AAC) typically presents at an early stage due to biliary obstruction and therefore might be specifically suitable for minimally invasive pancreatoduodenectomy (MIPD). However, studies assessing MIPD specifically for AAC, including the robotic and laparoscopic approach, are limited. The aim of this study is to compare short- and long-term oncological resection and perioperative outcomes of robotic (RPD), laparoscopic (LPD) and open pancreatoduodenectomy (OPD) performed specifically for AAC. Methods: In this multicenter international cohort study, encompassing 35 centers from 11 countries, MIPD versus OPD and subgroup analyses of LPD versus RPD were undertaken. The primary outcomes regarded the oncological resection (R1 resection rate, lymph node yield) and 5-years overall survival. Secondary outcomes were perioperative outcomes (including intra-operative variables, surgical complications and hospital stay). Results: In total, patients with AAC who underwent OPD (1721) or MIPD (141) were included. After propensity-score matching, 134 patients per cohort were included. The MIPD group consisted of 53 RPDs and 71 LPDs (50 per group after PSM). There was no difference in overall survival between MIPD and OPD (61.6 % vs 56.2 %, P = 0.215). In the MIPD group, operative time was longer (439 vs 360 min, P < 0.001). Between RPD and LPD, overall survival was not significantly different (75.8 % vs 47.4 %, P = 0.098) and lymph node yield was higher in RPD (21 vs 18, P = 0.014). Conclusion: In conclusion, patients with AAC seem to have comparable oncological resection and perioperative outcomes from MIPD compared to the traditional OPD. Both RPD as LPD appear to be safe alternatives for patients with AAC, which warrants confirmation by future randomized studies.

引用

页码：318 / 329

页数：12

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