Langenbeck's Archives of Surgery

, Volume 399, Issue 7, pp 849–856 | Cite as

Hybrid laparoscopic versus open pylorus-preserving pancreatoduodenectomy: retrospective matched case comparison in 80 patients

  • Ulrich Friedrich Wellner
  • Simon Küsters
  • Olivia Sick
  • Caroline Busch
  • Dirk Bausch
  • Peter Bronsert
  • Ulrich Theodor Hopt
  • Konrad Wojciech Karcz
  • Tobias Keck
Original Article



We compared the outcome of hybrid laparoscopic pylorus-preserving pancreatoduodenectomy (lapPPPD) and open PPPD (oPPPD) in a retrospective case-matched study.


Patients operated from 2010 to 2013 by lapPPPD were matched 1:1 for age, sex, histopathology, American Society of Anesthesiologists category and body mass index to oPPPD patients operated from 1996 to 2013.


Patients eligible for lapPPPD are a risk group due to a high rate of soft pancreata. Complication rate and mortality were comparable to oPPPD. There was a significantly reduced transfusion requirement and a trend towards shorter operation time, less delayed gastric emptying, and reduced hospital stay. The main reason for conversion was portal venous tumor adhesion. Patient selection changed and operation time and hospital stay decreased with the surgeons’ experience.


In selected patients, a hybrid laparoscopic technique of pancreatoduodenectomy is feasible with complication rates comparable to the open procedure. There seem to be advantages in terms of transfusion requirement, operation time, and hospital stay.


Laparoscopic surgery Minimally invasive surgery Pancreatic surgery Pancreatoduodenectomy 


Authors’ contributions

TK, UFW, and SK contributed to the study conception and design; TK, KWK, SK, DB, and UFW for the operations; PB for the histopathological assessment; and OS, CB, and PB for the data acquisition. UFW, CB, and SK analyzed and interpreted the data. UFW, CB, and SK drafted the manuscript. Critical revision of the manuscript was done by TK, UTH, DB, and KWK.

Conflicts of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Ulrich Friedrich Wellner
    • 1
  • Simon Küsters
    • 2
  • Olivia Sick
    • 2
  • Caroline Busch
    • 1
  • Dirk Bausch
    • 1
  • Peter Bronsert
    • 3
    • 4
  • Ulrich Theodor Hopt
    • 2
  • Konrad Wojciech Karcz
    • 1
  • Tobias Keck
    • 1
  1. 1.Clinic for SurgeryUniversity Hospital Schleswig HolsteinLübeckGermany
  2. 2.Clinic for General and Visceral SurgeryUniversity Medical Center FreiburgFreiburgGermany
  3. 3.Institute of PathologyUniversity of Freiburg Medical CenterFreiburgGermany
  4. 4.Comprehensive Cancer CenterUniversity of Freiburg Medical CenterFreiburgGermany

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