title: Hybrid laparoscopic versus open pylorus-preserving pancreatoduodenectomy: retrospective matched case comparison in 80 patients.
abstract: OBJECTIVE
  We compared the outcome of hybrid laparoscopic pylorus-preserving pancreatoduodenectomy (lapPPPD) and open PPPD (oPPPD) in a retrospective case-matched study.
  
  
  METHODS
  Patients operated from 2010 to 2013 by lapPPPD were matched 1:1 for age, sex, histopathology, American Society of Anesthesiologists category and body mass index to oPPPD patients operated from 1996 to 2013.
  
  
  RESULTS
  Patients eligible for lapPPPD are a risk group due to a high rate of soft pancreata. Complication rate and mortality were comparable to oPPPD. There was a significantly reduced transfusion requirement and a trend towards shorter operation time, less delayed gastric emptying, and reduced hospital stay. The main reason for conversion was portal venous tumor adhesion. Patient selection changed and operation time and hospital stay decreased with the surgeons' experience.
  
  
  CONCLUSIONS
  In selected patients, a hybrid laparoscopic technique of pancreatoduodenectomy is feasible with complication rates comparable to the open procedure. There seem to be advantages in terms of transfusion requirement, operation time, and hospital stay.
authors: Clinic for Surgery, University Hospital Schleswig Holstein, Campus Lübeck, 23538, Lübeck, Germany, dr.ulrich.wellner@gmail.com.
authors: Ulrich Friedrich
authors: UF
authors: Wellner
authors: Simon
authors: S
authors: Küsters
authors: Olivia
authors: O
authors: Sick
authors: Caroline
authors: C
authors: Busch
authors: Dirk
authors: D
authors: Bausch
authors: Peter
authors: P
authors: Bronsert
authors: Ulrich Theodor
authors: UT
authors: Hopt
authors: Konrad Wojciech
authors: KW
authors: Karcz
authors: Tobias
authors: T
authors: Keck
mesh_terms: D061887:Conversion to Open Surgery / Q000706:statistics & numerical data; D005260:Female; D005746:Gastric Emptying; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D016555:Matched-Pair Analysis; D059351:Organ Sparing Treatments; D010182:Pancreatic Diseases / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000453:epidemiology; D011708:Pylorus; D016896:Treatment Outcome