title: Laparoscopic-assisted versus open pancreaticoduodenectomy: early favorable physical quality-of-life measures.
abstract: BACKGROUND
  We compared outcomes and postpancreatectomy quality of life (QOL) in paired cohorts of patients undergoing conventional open pancreaticoduodenectomy (OPD) or laparoscopic-assisted pancreaticoduodenectomy (LAPD).
  
  
  METHODS
  Comparative analysis of QOL was performed in a matched cohort of 53 patients after OPD or LAPD between 2010 and 2013. The Medical Outcomes Study Short Form-36 Health Survey and the Karnofsky score were used.
  
  
  RESULTS
  Physical component score, mental component score, and Karnofsky scores were calculated at multiple time points for OPD (n = 25) and LAPD (n = 28). Operative times, complications, and readmission rates were equivalent. Time to starting adjuvant therapy trended toward clinical importance in LAPD (61 vs 110 days, P = .0878). Duration of stay was less in LAPD (7.10 vs 9.44 days, P = .02). LAPD had a superior QOL centered on functional status compared with OPD (physical component score 49.09 vs 38.4, P = .04; Karnofsky 92.22 vs 66.92%, P = .003). These statistical differences were not observed beyond 6 months.
  
  
  CONCLUSIONS
  LAPD provided a more favorable QOL within the first 6 months and shorter length of stay compared with conventional OPD. LAPD may serve as an alternative operative therapy to potentially minimize delays in receipt of and enhance tolerability of adjuvant therapies.
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC. Electronic address: Russell.C.Langan@gunet.georgetown.edu.
authors.forename: Russell C
authors.initials: RC
authors.lastname: Langan
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Jay A
authors.initials: JA
authors.lastname: Graham
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Anne B
authors.initials: AB
authors.lastname: Chin
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Aaron J
authors.initials: AJ
authors.lastname: Rubinstein
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Kesha
authors.initials: K
authors.lastname: Oza
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Jeff A
authors.initials: JA
authors.lastname: Nusbaum
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: John
authors.initials: J
authors.lastname: Smirniotopoulos
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Reilly
authors.initials: R
authors.lastname: Kayser
authors.affiliation: Department of Radiology, Georgetown University Hospital, Washington, DC.
authors.forename: Reena
authors.initials: R
authors.lastname: Jha
authors.affiliation: Department of Gastroenterology, Georgetown University Hospital, Washington, DC.
authors.forename: Nadim
authors.initials: N
authors.lastname: Haddad
authors.affiliation: Department of Gastroenterology, Georgetown University Hospital, Washington, DC.
authors.forename: Firas
authors.initials: F
authors.lastname: Al-Kawas
authors.affiliation: Department of Gastroenterology, Georgetown University Hospital, Washington, DC.
authors.forename: John
authors.initials: J
authors.lastname: Carroll
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Jane
authors.initials: J
authors.lastname: Hanna
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Ann
authors.initials: A
authors.lastname: Parker
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Waddah B
authors.initials: WB
authors.lastname: Al-Refaie
authors.affiliation: Department of Surgery, Georgetown University Hospital, Washington, DC.
authors.forename: Lynt B
authors.initials: LB
authors.lastname: Johnson
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000601:surgery; D015331:Cohort Studies; D004379:Duodenal Neoplasms / Q000601:surgery; D005260:Female; D006801:Humans; D017567:Karnofsky Performance Status; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011788:Quality of Life; D012189:Retrospective Studies; D016896:Treatment Outcome