title: Laparoscopic pancreaticoduodenectomy for adenocarcinoma provides short-term oncologic outcomes and long-term overall survival rates similar to those for open pancreaticoduodenectomy.
abstract: BACKGROUND
  The long-term efficacy of laparoscopic pancreaticoduodenectomy (LPD) relative to open pancreaticoduodenectomy (OPD) for pancreatic adenocarcinoma has not been well studied.
  
  
  METHODS
  The National Cancer Data Base was used to compare patients undergoing LPD and OPD for stage I-II pancreatic adenocarcinoma between 2010 and 2013.
  
  
  RESULTS
  828 (10%) patients underwent LPD and 7385 (90%) OPD. There were no differences in tumor or demographic characteristics between groups. On multivariable analysis adjusted for hospital volume, LPD was associated with a lower rate of readmission (p < 0.01) and trends toward shorter initial length of stay (p = 0.14) and time to adjuvant chemotherapy (p = 0.11). There were no differences between patients undergoing LPD and those undergoing OP in rates of margin negative resection, number of lymph nodes examined, perioperative mortality and median overall survival (20.7 vs 20.9 months, p = 0.68).
  
  
  CONCLUSIONS
  For patients with localized pancreatic adenocarcinoma, LPD provides short-term oncologic and long-term overall survival outcomes identical to OPD and is associated with decreased rates of readmission and a trend towards accelerated recovery.
authors.affiliation: Department of Surgery, University of Chicago, Chicago, IL, United States.
authors.forename: Olga
authors.initials: O
authors.lastname: Kantor
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Mark S
authors.initials: MS
authors.lastname: Talamonti
authors.affiliation: Department of Surgery, University of Chicago, Chicago, IL, United States; Department of Surgery, MetroHealth Medical Center, Cleveland, OH, United States.
authors.forename: Susan
authors.initials: S
authors.lastname: Sharpe
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States.
authors.forename: Waseem
authors.initials: W
authors.lastname: Lutfi
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Winchester
authors.affiliation: Department of Surgery, University of Chicago, Chicago, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Kevin K
authors.initials: KK
authors.lastname: Roggin
authors.affiliation: Department of Surgery, Northwestern University, Chicago, IL, United States.
authors.forename: David J
authors.initials: DJ
authors.lastname: Bentrem
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Prinz
authors.affiliation: Department of Surgery, NorthShore University HealthSystem, Evanston, IL, United States; Pritzker School of Medicine, University of Chicago, Chicago, IL, United States. Electronic address: Mbaker3@northshore.org.
authors.forename: Marshall S
authors.initials: MS
authors.lastname: Baker
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000601:surgery*; D000368:Aged; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D010359:Patient Readmission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
keywords: Laparoscopic pancreaticoduodenectomy; Oncological efficacy; Overall survival