LAPAROSCOPIC ASSISTED VS OPEN WHIPPLE'S PANCREATICODUODONECTOMY - A RCT dr.asurikrishna@gmail.com

 

LAPAROSCOPIC ASSISTED VS OPEN WHIPPLE'S PANCREATICODUODONECTOMY - A RCT

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India

Oral or Poster

Laparoscopic-assisted pancreaticoduodenectomy (LAPD) is proposed to reduce early postoperative morbidity compared with open pancreaticoduodenectomy (OPD), but high-quality comparative data remain limited in India. This single-centre randomized controlled superiority trial compared early outcomes after LAPD vs OPD.

Adults undergoing pancreaticoduodenectomy at a high-volume tertiary centre were randomized (block randomization; open-label, two-arm, intention-to-treat). The primary outcome was early postoperative morbidity per ISGPS; secondary outcomes included 30-day mortality, pain (VAS), hospital stay, and EuroQol quality of life (QOL) at 3 months. Ethics approval and CTRI registration were obtained

Sixty-seven patients were analysed (LAPD = 27; OPD = 40). Baseline characteristics were comparable. ISGPS-defined delayed gastric emptying (DGE) was the most frequent complication (overall 44.78%: LAPD 40.74% vs OPD 47.5%, p=0.433). Clinically relevant POPF (Grade B/C) was not observed in either group. Wound events were similar (LAPD 21.21% vs OPD 25.0%; p=0.82. Hospital stay tended to be shorter after LAPD (mean 16.44 vs 21.2 days; p=0.171). Re-admission was 11.11% (LAPD) vs 15% (OPD. Pain scores (VAS) fell similarly in both groups at day 1, 1 month, and 3 months (all p>0.05), and QOL at 3 months was comparable (10.65 ± 1.94 vs 10.89 ± 2.26; p=0.67). Thirty-day mortality showed a non-significant trend favoring LAPD (3.7% vs 10%).

In this randomized trial, LAPD was non-inferior to OPD for early postoperative morbidity and mortality, with signals toward shorter hospital stay and fewer wound-related issues