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Compare open and laparoscopic assisted pancreaticoduodenectomy regarding intraoprative blood loss, organ injury, completion of planned laparoscopic steps, duration and early post operative course of pain, hem stability, oral feeding, leakage(pancreatic, billary and intestinal). ,bleeding, mortality, lymph nodes and safety margins .
Pancreaticoduodenectomy is the only option curative intended in the treatment of resectable pancreatic ductal adenocarcinomas, duodenal carcinoma, ampullary carcinoma, lower common bile duct cholangiocarcinoma,. It is still associated with very high morbidity and mortality. [1]. Pancreatic cancer ranks as the seventh leading cause of cancer-related death worldwide, and the fourth among other cancers[2,3]. In recent years, the minimally invasive techniques has considered revolution in surgeries of pancreatic cancers [4,5]. Laparoscopic assisted pancreaticoduodenectomy is a hybrid procedure combining laparoscopic resection and reconstruction through a small incision.it companies laparoscopic mobilization and dissection due to magnification compared with open pancreaticoduodenectomy[6]. Several studies have shown that laparoscopic assisted pancreaticoduodenectomy could result in less blood loss less, pain ,less wound infection and shorter hospital stay compared to open pancreaticoduodenectomy[7,8]. Limited literature described the safety and efficacy of laparoscopic assisted pancraticododenostomy .Also such comparative studies deficient in evaluation of outcomes of laparoscopic assisted pancraticododenostomy and open pancraticoduodenoctomy.So the interest of our study is to compare between the feasibility and safety of laparoscopic assisted pancraticododenostomy and open pancraticoduodenoctomy.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Laparoscopic assisted pancreaticoduodenctomy | Experimental | If inclusion criteria are met ,these group of patients will undergo Laparoscopic assisted pancreaticoduodenctomy. |
|
| Open pancreaticduodenctomy | Active Comparator | criteria are met ,these group of patients will undergo open pancreaticoduodenctomy |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| laparoscopic assisted pancreaticoduodenectomy | Procedure | laparoscopic assisted pancreaticoduodenectomy. |
|
| Measure | Description | Time Frame |
|---|---|---|
| post operative pain. | Compare the post operative pain betweenopen and laparoscopic assisted pancreaticoduodenectomy | Compare the post operative pain between open and laparoscopic assisted pancreaticoduodenctomy in the first week after operation |
| Blood loss | Compare between the intra operative blood loss in the open and laparoscopic assisted pancreaticoduodenectomy | Compare the intra operative blood loss between open and laparoscopic assisted pancreaticoduodenectomy during the operation |
| Rate of postoperative anastomosis leakage(pancreatic,billary and intestinal). | Compare the rate of postoperative anastomosis leakage(pancreatic,billary and intestinal) between the open and laparoscopic assisted pancreaticoduodenctomy | Rate of postoperative anastomosis leakage(pancreatic,billary and intestinal) in the first month after operation |
| Measure | Description | Time Frame |
|---|---|---|
| Postoperative haemorrhage | Compare between the postoperative haemorrhage by cc in the open and laparoscopic assisted pancreaticoduodenectomy | In the first 2 weeks |
| Postoperative wound infection. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| mohammed aly ahmed, Assist.lecturer | Contact | 01067575588 | mohamed1234ali1991@gmail.com | |
| Mostafa Mahmoud Mohammed Sayed, Assist.prof | Contact | +201271207839 | mostafa.sayed@aun.edu.eg |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 25801594 | Background | Newhook TE, LaPar DJ, Lindberg JM, Bauer TW, Adams RB, Zaydfudim VM. Morbidity and mortality of pancreaticoduodenectomy for benign and premalignant pancreatic neoplasms. J Gastrointest Surg. 2015 Jun;19(6):1072-7. doi: 10.1007/s11605-015-2799-y. Epub 2015 Mar 24. | |
| 34232515 | Background | Erratum to "Cancer statistics, 2021". CA Cancer J Clin. 2021 Jul;71(4):359. doi: 10.3322/caac.21669. Epub 2021 Apr 19. No abstract available. |
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| ID | Term |
|---|---|
| D010190 | Pancreatic Neoplasms |
| ID | Term |
|---|---|
| D004067 | Digestive System Neoplasms |
| D009371 | Neoplasms by Site |
| D009369 | Neoplasms |
| D004701 | Endocrine Gland Neoplasms |
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| Open pancreaticduodenctomy | Procedure | Open pancreaticduodenctomy |
|
Compare between the postoperative wound infection in the open and laparoscopic assisted pancreaticoduodenectomy
| In the first 2 weeks |
| Starting oral feeding | Compare between starting oral feeding in the open and laparoscopic assisted pancreaticoduodenectomy | In the first 3 days after operation |
| Postoperative 30 days mortality rate. | Compare between the Postoperative 30 days mortality rate in the open and laparoscopic assisted pancreaticoduodenectomy | In the first 30days after operation |
| 32061329 | Background | Correction to Lancet Gastroenterol Hepatol 2019; 4: 934-47. Lancet Gastroenterol Hepatol. 2020 Mar;5(3):e2. doi: 10.1016/S2468-1253(20)30018-2. No abstract available. |
| 30675490 | Background | Bausch D, Keck T. Minimally Invasive Surgery of Pancreatic Cancer: Feasibility and Rationale. Visc Med. 2018 Dec;34(6):440-443. doi: 10.1159/000495324. Epub 2018 Nov 28. |
| D004066 |
| Digestive System Diseases |
| D010182 | Pancreatic Diseases |
| D004700 | Endocrine System Diseases |