{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T01:56:13Z","timestamp":1792634173657,"version":"4.5.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T00:00:00Z","timestamp":1635292800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>To compare perioperative and oncological outcomes of pancreatic duct adenocarcinoma (PDAC) after laparoscopic <jats:italic>versus<\/jats:italic> open pancreaticoduodenectomy (LPD <jats:italic>vs.<\/jats:italic> OPD), we performed a meta-analysis of currently available propensity score matching studies and large-scale retrospective cohorts to compare the safety and overall effect of LPD to OPD for patients with PDAC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A meta-analysis was registered at PROSPERO and the registration number is CRD42021250395. PubMed, Web of Science, EMBASE, Cochrane Central Register of Controlled Trials, and ClinicalTrials.gov databases were searched based on a defined search strategy to identify eligible studies before March 2021. Data on operative times, blood loss, 30-day mortality, reoperation, length of hospital stay (LOS), overall morbidity, Clavien\u2013Dindo \u22653 complications, postoperative pancreatic fistula (POPF), blood transfusion, delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), and oncologic outcomes (R0 resection, lymph node dissection, overall survival, and long-term survival) were subjected to meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, we identified 10 retrospective studies enrolling a total of 11,535 patients (1,514 and 10,021 patients underwent LPD and OPD, respectively). The present meta-analysis showed that there were no significant differences in overall survival time, 1-year survival, 2-year survival, 30-day mortality, Clavien-Dindo \u22653 complications, POPF, DGE, PPH, and lymph node dissection between the LPD and OPD groups. Nevertheless, compared with the OPD group, LPD resulted in significantly higher rate of R0 resection (OR: 1.22; 95% CI 1.06\u20131.40; <jats:italic>p<\/jats:italic> = 0.005), longer operative time (WMD: 60.01 min; 95% CI 23.23\u201396.79; <jats:italic>p<\/jats:italic> = 0.001), lower Clavien\u2013Dindo grade \u2265III rate (<jats:italic>p<\/jats:italic> = 0.02), less blood loss (WMD: \u221296.49 ml; 95% CI \u2212165.14 to \u221227.83; <jats:italic>p<\/jats:italic> = 0.006), lower overall morbidity rate (OR: 0.65; 95% CI 0.50 to 0.85; <jats:italic>p<\/jats:italic> = 0.002), shorter LOS (MD = \u22122.73; 95% CI \u22124.44 to \u22121.03; <jats:italic>p<\/jats:italic>\u00a0= 0.002), higher 4-year survival time (<jats:italic>p<\/jats:italic> = 0.04), 5-year survival time (<jats:italic>p<\/jats:italic> = 0.001), and earlier time to starting adjuvant chemotherapy after surgery (OR: \u221210.86; 95% CI \u221219.42 to \u22122.30; <jats:italic>p<\/jats:italic> = 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>LPD is a safe and feasible alternative to OPD for patients with PDAC, and compared with OPD, LPD seemed to provide a similar OS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/PROSPERO\/#recordDetails<\/jats:uri>.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2021.749140","type":"journal-article","created":{"date-parts":[[2021,10,27]],"date-time":"2021-10-27T06:26:16Z","timestamp":1635315976000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":27,"title":["Laparoscopic Pancreaticoduodenectomy Versus Conventional Open Approach for Patients With Pancreatic Duct Adenocarcinoma: An Up-to-Date Systematic Review and 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