Comparison of outcomes of laparoscopic and open <scp>pancreaticoduodenectomy</scp>: An updated meta‐analysis

Abstract Objective Laparoscopic pancreaticoduodenectomy (LPD) is an alternative to the open surgical approach. Several authors have investigated the advantages of LPD over open PD (OPD); this study aims to evaluate the effectiveness of LPD compared with OPD. Methodology This study conducted a meta‐analysis following the Cochrane Handbook for Systematic Reviews and adhering to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. Multiple databases—including PubMed, the Cochrane Trial Register, and Google Scholar—were searched for relevant literature up to April 20, 2024. Studies comparing OPD with LPD were included. Results A total of 4 randomized controlled trials and 41 non‐randomized comparative trials were analysed. No significant difference in post‐operative mortality was found ( P = .42). However, there was a significant reduction in overall post‐operative complications in the LPD group ( P &lt; .002). The length of hospital stay was also significantly shorter in the LPD group ( P &lt; .00001). No significant differences were observed between LPD and OPD regarding post‐operative pancreatic fistula ( P = .93) and post‐pancreatectomy haemorrhage (post‐pancreatectomy haemorrhage; P = .19). However, the rate of post‐operative bile leaks was higher in the LPD group compared with the OPD group ( P = .02). Conclusion This study concluded that LPD is a safer approach with less post‐operative complications, longer operative time, less estimated blood loss, and shorter hospital stays when compared with OPD.