Extended Pancreatic Transection Versus Conventional Pancreatic Transection During Laparoscopic Pancreaticoduodenectomy

Xinrui Zhu，MD

Status: Not yet enrolling

Conditions: Laparoscopic Pancreaticoduodenectomy

Treatments: Procedure: extended pancreatic transection during laparoscopic pancreaticoduodenectomy

Study type: Observational

Funder types: Other

Identifiers

NCT05905549

2023-167-2

Details and patient eligibility

About

The level of pancreatic neck transection during laparoscopic pancreaticoduodenectomy (LPD) is not conclusive. Theoretically, the level of pancreatic transection can significantly affect the occurrence of postoperative pancreatic fistula (POPF) by influencing both the blood supply to the anastomosis and the location of the main pancreatic duct in the pancreatic transverse section. The investigators conduct a retropective propensity score-matched comparison to compare the impact of extended pancreatic transection and conventional pancreatic transection on POPF and the performance of the pancreaticojejunostomy during LPD.

Enrollment: 184 estimated patients

Sex: All

Ages: 18 to 90 years old

Volunteers: No Healthy Volunteers

Inclusion criteria

1. consecutive patients underwent elective laparoscopic pancreaticoduodenectomy within October 2019 to April 2023
2. the perioperative and follow-up study data information can be collected completely
3. The level of pancreatic neck dissection can be determined by postoperative abdominal CT
4. patients without the history of neoadjuvant chemotherapy or radiotherapy

Exclusion criteria

1. conversion to laparotomy due to various reasons during operation;
2. combined with resection and reconstruction of the portal vein or the superior mesenteric vein
3. combined with other organ resection
4. the perioperative and follow-up study data information can not be collected completely, or the level of pancreatic neck dissection can not be determined by postoperative abdominal CT
5. patients with the history of neoadjuvant chemotherapy or radiotherapy
6. the main pancreatic duct did not be found during the operation, the duct-to-mucosa pancreaticojejunostomy could not be performed

Trial design

184 participants in 2 patient groups

extended pancreatic transection cohort

Description:

cases in which the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan.

Treatment:

Procedure: extended pancreatic transection during laparoscopic pancreaticoduodenectomy

conventional pancreatic transection cohort

Description:

cases in which the pancreatic transection was performed at the pancreatic neck above the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan.