Pancreatic cancer: Open or minimally invasive surgery?

Table 1 Safety and feasibility of laparoscopic pancreaticoduodenectomy: Clinical cohorts of minimally invasive pancreaticoduodenectomy and open pancreaticoduodenectomy including comparative results

Ref.	Year	Country	Technique	Cases	Operating time, min	EBL, mL	LHS, D	CD≥III	PF	DGE	Readmission rate	Mortality
Sharp et al[21]	2015	United States	LPD	384	NR	NR	NR	NR	NR	NR	5.0%	5.2% (30 D)
			OPD	4037	NR	NR	NR	NR	NR	NR	9.0%	3.7% (30 D)
Song et al[16]	2015	SouthKorea	LPPPD	93	482.5 ± 117.6	609 ± 375	14.3 ± 7.8	7.5%	6 (6.5)	3.2%	5 (5.4)	NR
			OPPPD	93	347.9 ± 87.2	570 ± 448	19.2 ± 8.8	5.4%	6 (6.5)	7.5%	3 (3.2)	NR
Chen et al[34]	2015	China	RPD	60	410 ± 103	400 (200-600)	20 ± 7.4	11.7%	13.3%	8.3%	NR	1.7%
			OPD	120	323 ± 80	500 (350-800)	25 ± 11.2	13.3%	24.9%	15.0%	NR	2.5%
Dokmak et al[24]	2015	France	LPD	46	342 (240-540)	368 (50-1200)	25 (6-104)	28.0%	48.0%	17.0%	9.0%	2.0%
			OPD	46	264 (120-400)	293 (50-1200)	23 (7-115)	20.0%	41.0%	15.0%	9.0%	0
Baker et al[31]	2015	United States	RPD	22	454 (294-529)	425 (50-2200)	7 (4-25)	13.6%	4.6%	13.6%	22.7%	0
			OPD	49	364 (213-948)	650 (150-6100)	9 (5-48)	20.4%	12.2%	30.6%	29.8%	4.1%
Tran et al[74]	2015	United States	LPD	681	NR	NR	12 (9-20)	NR	NR	NR	NR	3.8%
			OPD	14893	NR	NR	11 (8-16)	NR	NR	NR	NR	5.0%
Tan et al[75]	2015	China	LPD	30	513.17 ± 56.13	NR	9.97 ± 3.74	NR	10/30	2/30	NR	0
			OPD	30	371.67 ± 85.53	NR	11.87 ± 4.72	NR	6/30	3/30	NR	1/30
Adam et al[32]	2015	United States	MIPD	983	NR	NR	NR	NR	NR	NR	4.8%	NR
			OPD	6078	NR	NR	NR	NR	NR	NR	3.7%	NR
Chalikonda et al[33]	2014	United States	HPD	30	476.00	485	9.79	30.0%	NR	NR	NR	4.0%
			OPD	30	366.48	775	13.26	43.0%	NR	NR	NR	0
Bao et al[76]	2014	United States	RPD	28	431 (340-628)	100 (50-300)	7.4 (5.5-17.1)	NR	29.0%	NR	25.0%	7.0% (90 D)
			OPD	28	410 (190-621)	300 (100-800)	8.1 (6.5-15.3)	NR	29.0%	NR	25.0%	7.0% (90 D)
Croome et al[20]	2014	United States	LPD	108	379.4 ± 93.5	492.4 ± 519.3	6 (4-118)	5.6% (≥ IIIb)	11% (B/C)	9% (B/C)	NR	1.0% (I H)
			OPD	214	387.6 ± 91.8	866.7 ± 733.7	9 (5-73)	13.6% (≥ IIIb)	12% (B/C)	18% (B/C)	NR	2.0% (I H)
Speicher et al[77]	2014	United States	LPD	25	381 (342-465)	200 (100-425)	8.5 (7-11.2)	NR	16% (B/C)	NR	30.4%	0 (30 D)
			HPD	31	442 (386.5-486.5)	600 (312.5-700)	12 (8.5-18.5)	NR	35.5%	NR	35.5%	3.2%(30 D)
			OPD	84	425.5 (345.8-478.8)	425 (300-700)	10 (8-14)	NR	22.6%	NR	39.3%	1.2% (30 D)
Asbun et al[11]	2012	United States	LPD	53	541 ± 88	195 ± 136	8.0 ± 3.2	NR	16.7%	11.3%	NR	5.7% (100 D)
			OPD	215	401 ± 108	1032 ± 1151	12.4 ± 8.5	NR	17.3%	15.3%	NR	8.8% (100 D)
Lai et al[28]	2012	China	RPD	20	491.5 ± 94.0	247 (50-889)	13.7 ± 6.1	NR	35.0%	5%	NR	0%
			OPD	67	264.9 ± 63.7	774.8 (50-8000)	25.8 ± 23.1	NR	17.9%	11.9%	NR	3%

CD: Clavien-Dindo; DGE: Delayed gastric emptying; EBL: Estimated blood loss; HPD: Hybrid pancreaticoduodenectomy; LHS: Length of hospital stay; LPD: Laparoscopic pancreaticoduodenectomy; LPPPD: Laparoscopic pylorus-preserving pancreaticoduodenectomy; MIPD: Minimally invasive pancreaticoduodenectomy; NR: Not reported; OPD: Open pancreaticoduodenectomy; OPPPD: Open pylorus-preserving pancreaticoduodenectomy; PF: Pancreatic fistula; RPD: Robotic pancreaticoduodenectomy.

Table 2 Oncological results of pancreatic cancer in minimally invasive pancreaticoduodenectomy and open pancreaticoduodenectomy: Clinical trials including comparative results of pancreatic ductal adenocarcinoma between minimally invasive pancreaticoduodenectomy and open pancreaticoduodenectomy

Ref.	Year	Country	Technique	No. of PDAC cases	Rate of R0 resection	No. of LN	Positive LN	Tumor size, cm
Sharp et al[21]	2015	United States	LPD	384	80.0%	18 ± 9.7	NR	3.2 ± 1.3
			OPD	4037	74.0%	16 ± 9.6	NR	3.3 ± 2.4
Song et al[16]	2015	South Korea	LPPPD	11	72.7%	15 ± 10	0.8 ± 1.2	2.8 ± 0.6
			OPPPD	261	81.0%	16.2 ± 9.6	1.5 ± 2.2	3.0 ± 1.2
Dokmak et al[24]	2015	France	LPD	15	60.0%	20 (8-59)	4.7 (0-32)	2.4 (1.5-4)
			OPD	14	50.0%	25 (8-47)	2.2 (0-12)	2.8 (2.5-4)
Chen et al[34]	2015	China	RPD	19	94.7%	18.1 ± 6.6	NR	3.0 ± 0.9
			OPD	38	92.1%	17.8 ± 7.1	NR	3.1 ± 1.0
Croome et al[20]	2014	United States	LPD	108	77.8%	21.4 ± 8.1	73.1%	3.3 ± 1.0
			OPD	214	76.6%	20.1 ± 7.5	72.0%	3.3 ± 1.3

LN: Lymph node; LPD: Laparoscopic pancreaticoduodenectomy; LPPPD: Laparoscopic pylorus-preserving pancreaticoduodenectomy; MIPD: Minimally invasive pancreaticoduodenectomy; OPD: Open pancreaticoduodenectomy; OPPPD: Open pylorus-preserving pancreaticoduodenectomy; PDAC: Pancreatic duct adenocarcinoma; NR: Not reported.