Adverse impact of intraoperative conversion on the postoperative course following laparoscopic pancreaticoduodenectomy

Law Cho Kwan Connie, Seung Soo Hong, Incheon Kang, Seung Yoon Rho, Ho Kyoung Hwang, Woo Jung Lee, Chang Moo Kang

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Purpose: The aim of the current study was to evaluate the adverse clinical impact of intraoperative conversion during laparoscopic pancreaticoduodenectomy (LPD). Materials and Methods: The medical records of patients who underwent pancreaticoduodenectomy (PD) were retrospectively reviewed. Perioperative clinical variables were compared between patients who underwent converted PD (cPD) and initially planned open PD (OPD) to investigate the clinical impact and predictive factors of intraoperative conversion during LPD. Results: A total of 171 patients were included. Among them, 31 patients (19.3%) were found to have intraoperative conversion during LPD. Failure of progression due to severe adhesion (12 patients, 7%) and major vessel invasion (7 patients, 4%) were the two most frequent reasons for conversion. On multivariate analysis, age [Exp(β)=1.044, p=0.044] and pancreatic texture [Expa(β)=2.431, p=0.039) were found to be independent factors for predicting intraoperative conversion during LPD. In comparative analysis with the OPD group, the cPD group had a longer operation time (516.8 min vs. 449.9 min, p=0.001), higher rate of postoperative hemorrhage (12.1% vs. 0.85%, p=0.008), higher reoperation rate (9.1% vs. 0%, p=0.01), and higher cost (21886.4 USD vs. 17168.9 USD, p=0.018). Conclusion: Intraoperative conversion during LPD can have an adverse clinical impact on the postoperative course following LPD. Appropriate patients selection and improvement of surgical techniques will be crucial for unnecessary intraoperative conversion and safe LPD.

Original languageEnglish
Pages (from-to)836-842
Number of pages7
JournalYonsei medical journal
Volume62
Issue number9
DOIs
Publication statusPublished - 2021 Sept

Bibliographical note

Publisher Copyright:
© Yonsei University College of Medicine 2021.

All Science Journal Classification (ASJC) codes

  • General Medicine

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