Résumé
Background: pancreatoduodenectomy (PD) is one of the most demanding surgical procedures for which the use of minimally invasive approaches is still debated. The present study aims to compare the outcomes after laparoscopic pancreatoduodenectomy (LPD) versus open pancreatoduodenectomy (OPD).Results: after exclusions, we included 132 patients for OPD between May 2007 and March 2018. 132 patients underwent LPD between April 2010 and January 2023. The groups were comparable for most baseline characteristics. Regarding our primary outcome, we did not find a significant difference for severe postoperative complications (Clavien-Dindo score ≥3) between the LPD and OPD group (16.7% vs 23.5%; p=0.16). There were no significant differences for postoperative complications, reoperation, readmission and 90-day mortality. Average operative time (OT) was 78 minutes longer in the LPD group (348.9 min +/- 82.1 vs 270.8 min +/- 74.5; p<0,0001). In patients with malignant disease (LPD n=116; OPD n=106), there were no differences with regard to the frequency of R0 resections, but patients in the LPD group had a higher average number of lymph nodes harvested (mean 16.2 +/- 7.1 vs 13.8 +/- 7.3; p=0.0087). Finally, length of stay was significantly shorter after LPD (median 12 days (range 7-72) vs 15 days (9-56); p=0.01). Conclusion: LPD is a safe and feasible procedure when done in high-volume centers by experienced pancreatic and laparoscopic surgeons. Our study indicates that LPD could lead to a shorter hospital stay with similar postoperative outcomes and short-term oncologic outcomes to OPD. Further studies are needed to investigate the impact of learning curve on postoperative outcomes and long-term oncologic outcomes.