Early outcomes of standard lymphadenectomy in laparoscopic pancreaticoduodenectomy for periampullary cancer

Abstract

Introduction: The quality of lymph node dissection plays an important role in laparoscopic pancreaticoduodenectomy for periampullary cancers and significantly affects the patient’s survival. Among the degrees of lymphadenectomy, the standard level is routinely performed in a range of centers. Therefore, it is necessary to evaluate the results of standard lymphadenectomy in laparoscopic pancreaticoduodenectomy for periampullary cancers.

Patients an Methods: This is a cross-sectional study. We analyzed the data from 65 cases witnessing laparoscopic pancreaticoduodenectomy with standard lymphadenectomy due to periampullary cancers from February 1^st, 2017 to January 31^st, 2022, at University Medical Center at Ho Chi Minh City.

Results: The average number of harvested lymph nodes was 16.6 ± 5.1. Positive lymph node happened in 50.9% of cases and mean of lymph node ratio (LNR) was 0.11. Three most common metastatic groups were group 13, 14 and 17. Intraoperative bleeding happened in 1 patient (1.5%) because of portal vein tear during lymph node dissection and postoperatively chylous fistula occurred in 2 cases, making up 3.1%. The case of intraoperative bleeding was converted to open surgery to control the bleeding. The patient was going well and discharged on the 8^th day after surgery. The two cases of chylous fistula were also going well and discharged on the 22^nd postoperative day.

Conclusion: Standard lymphadenectomy in laparoscopic pancreaticoduodenectomy can meet the requirements for the number of harvested lymph nodes in the principles of cancer treatment and having the low rate of complications related to lymph node dissection.

Keywords: lymphadenectomy, harvested lymph node, laparoscopic pancreaticoduodenectomy, periampullary cancer

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