Extended Pancreatic Transection Versus Conventional Pancreatic Transection During Laparoscopic Pancreaticoduodenectomy

NCT05905549 | Unknown

• 1 other identifier: 2023-167-2
• Study Type: observational
• Target: 184
• Locations: 0 countries
• Sites: N/A

Brief Summary

The level of pancreatic neck transection during laparoscopic pancreaticoduodenectomy (LPD) is not conclusive. Theoretically, the level of pancreatic transection can significantly affect the occurrence of postoperative pancreatic fistula (POPF) by influencing both the blood supply to the anastomosis and the location of the main pancreatic duct in the pancreatic transverse section. The investigators conduct a retropective propensity score-matched comparison to compare the impact of extended pancreatic transection and conventional pancreatic transection on POPF and the performance of the pancreaticojejunostomy during LPD.

Conditions

Laparoscopic Pancreaticoduodenectomy

Keywords

laparoscopic pancreaticoduodenectomy; pancreatic transection level

Outcome Measures

Primary Outcomes (1)

• the incidence of clinically relevant pancreatic fistula

  the incidence of the clinically relevant pancreatic fistula according the International Study Group of Pancreatic Surgery's definition and grading

  3 months postoperatively

Secondary Outcomes (3)

• surgical performance of pancreaticojejunostomy

  intraoperatively

• postoperative morbidity

  3 months postoperatively

• postoperative mortality

  3 months postoperatively

Study Arms (2)

extended pancreatic transection cohort

cases in which the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan.

Procedure: extended pancreatic transection during laparoscopic pancreaticoduodenectomy

conventional pancreatic transection cohort

cases in which the pancreatic transection was performed at the pancreatic neck above the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy, as judged by postoperative abdominal CT scan.

Interventions

extended pancreatic transection during laparoscopic pancreaticoduodenectomy PROCEDURE

the pancreatic transection was performed at the pancreatic neck beyond the left side of the mesenterico-portal axis during laparoscopic pancreaticoduodenectomy

extended pancreatic transection cohort

Eligibility Criteria

• Age: 18 Years - 90 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

patients who had underwent laparoscopic pancreaticoduodenectomy

You may qualify if:

• consecutive patients underwent elective laparoscopic pancreaticoduodenectomy within October 2019 to April 2023
• the perioperative and follow-up study data information can be collected completely
• The level of pancreatic neck dissection can be determined by postoperative abdominal CT
• patients without the history of neoadjuvant chemotherapy or radiotherapy

You may not qualify if:

• conversion to laparotomy due to various reasons during operation;
• combined with resection and reconstruction of the portal vein or the superior mesenteric vein
• combined with other organ resection
• the perioperative and follow-up study data information can not be collected completely, or the level of pancreatic neck dissection can not be determined by postoperative abdominal CT
• patients with the history of neoadjuvant chemotherapy or radiotherapy
• the main pancreatic duct did not be found during the operation, the duct-to-mucosa pancreaticojejunostomy could not be performed

Sponsors & Collaborators

• Xinrui Zhu，MD: lead

Related Publications (3)

• Bardol T, Delicque J, Hermida M, Herrero A, Guiu B, Fabre JM, Souche R. Neck transection level and postoperative pancreatic fistula after pancreaticoduodenectomy: A retrospective cohort study of 195 patients. Int J Surg. 2020 Oct;82:43-50. doi: 10.1016/j.ijsu.2020.08.001. Epub 2020 Aug 22.

  PMID: 32841726 BACKGROUND

• Jwa EK, Hwang S. Extended pancreatic transection for secure pancreatic reconstruction during pancreaticoduodenectomy. Ann Hepatobiliary Pancreat Surg. 2017 Aug;21(3):138-145. doi: 10.14701/ahbps.2017.21.3.138. Epub 2017 Aug 31.

  PMID: 28990000 BACKGROUND

• Strasberg SM, Drebin JA, Mokadam NA, Green DW, Jones KL, Ehlers JP, Linehan D. Prospective trial of a blood supply-based technique of pancreaticojejunostomy: effect on anastomotic failure in the Whipple procedure. J Am Coll Surg. 2002 Jun;194(6):746-58; discussion 759-60. doi: 10.1016/s1072-7515(02)01202-4.

  PMID: 12081065 BACKGROUND

Study Officials

• Bing Peng

  West China Hospital

  STUDY CHAIR

Central Study Contacts

Yunqiang Cai

CONTACT

+862862539242; yunqiangcaiwch@163.com

Bing Peng

CONTACT

pengbing84@hotmail.com

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: attending doctor

Study Record Dates

• First Submitted: June 5, 2023
• First Posted: June 15, 2023
• Study Start: August 1, 2023
• Primary Completion: December 30, 2023
• Study Completion: June 30, 2024
• Last Updated: July 18, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share