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This individual patient data meta-analysis evaluates MIPD versus OPD in NPPC patients, using studies from Pubmed, Embase, and Cochrane, with predefined short- and long-term endpoints.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/the-clinical-implication-of-minimally-invasive-versus-open-pancreatoduodenectomy-for-non-pancreatic-periampullary-cancer-a-systematic-review-and-individual-patient-data-meta-analysis/383937/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/the-clinical-implication-of-minimally-invasive-versus-open-pancreatoduodenectomy-for-non-pancreatic-periampullary-cancer-a-systematic-review-and-individual-patient-data-meta-analysis/383937.png","ImageObject",300,407,{"name":92,"@type":93},"Fahsai","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-30","2026-09-24",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What question does this meta-analysis address?","Question",{"text":112,"@type":113},"It assesses the clinical implications of minimally invasive pancreatoduodenectomy versus open pancreatoduodenectomy in patients with non-pancreatic periampullary cancer, including subgroup effects.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the evidence collected for the analysis?",{"text":117,"@type":113},"A systematic review searched Pubmed, Embase, and Cochrane databases, and individual patient data were required from all included studies comparing MIPD and OPD for NPPC between 01/2015 and 12/2021.",{"name":119,"@type":110,"acceptedAnswer":120},"Which outcomes were compared between MIPD and OPD?",{"text":121,"@type":113},"The study compared 90-day mortality and major morbidity (Clavien-Dindo 3a–5), and also evaluated postoperative pancreatic fistula, delayed gastric emptying, postpancreatectomy hemorrhage, blood loss, length of hospital stay, and overall survival.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},383937,1790363019,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},549768702563,"https://ap-avatar.wpscdn.com/avatar/8000c4aa63b76e948b?x-image-process=image/resize,m_fixed,w_180,h_180&k=1786536092046926083","Langenbeck's Archives of Surgery (2023) 408:311 [https://doi.org/10.1007/s00423-023-03047-4](https://doi.org/10.1007/s00423-023-03047-4)  \nThe clinical implication of minimally invasive versus open  \npancreatoduodenectomy for non‑pancreatic periampullary cancer: a systematic review and individual patient data meta‑analysis  \nBas A. Uijterwijk1,2 · Meidai Kasai3 · Daniel H. L. Lemmers1,2 · Palanivelu Chinnusamy4 · Jony van Hilst2,5 · Benedetto Ielpo6 · Kongyuan Wei7 · Ki Byung Song8 · Song C. Kim8 · Sjors Klompmaker2 · Jin‑Young Jang9 ·  \nKelly M. Herremans10 · Lapo Bencini11 · Andrea Coratti12 · Michele Mazzola13 · Krishna V. Menon14 · Brian K. P. Goh15 · Renyi Qin16 · Marc G. Besselink2 · Mohammed Abu Hilal1 · for the International Study Group on non‑pancreatic periAmpullary CAncer (ISGACA)  \nReceived: 12 April 2023 / Accepted: 3 August 2023 / Published online: 15 August 2023 © The Author(s) 2023  \nAbstract  \nBackground Most studies on minimally invasive pancreatoduodenectomy (MIPD) combine patients with pancreatic and periampullary cancers even though there is substantial heterogeneity between these tumors. Therefore, this study aimed to evaluate the role of MIPD compared to open pancreatoduodenectomy (OPD) in patients with non-pancreatic periampullary cancer (NPPC) .  \nMethods A systematic review of Pubmed, Embase, and Cochrane databases was performed by two independent reviewers to identify studies comparing MIPD and OPD for NPPC (ampullary, distal cholangio, and duodenal adenocarcinoma)(01/2015–12/2021) . Individual patient data were required from all identified studies. Primary outcomes were (90-day) mortality, and major morbidity (Clavien-Dindo 3a-5) . Secondary outcomes were postoperative pancreatic fistula (POPF), delayed gastric emptying (DGE), postpancreatectomy hemorrhage (PPH), blood-loss, length of hospital stay (LOS), and overall survival (OS) .  \nResults Overall, 16 studies with 1949 patients were included, combining 928 patients with ampullary, 526 with distal cholangio, and 461 with duodenal cancer. In total, 902 (46.3%) patients underwent MIPD, and 1047 (53.7%) patients underwent OPD. The rates of 90-day mortality, major morbidity, POPF, DGE, PPH, blood-loss, and length of hospital stay did not differ between MIPD and OPD. Operation time was 67 min longer in the MIPD group (P = 0.009) . A decrease in DFS for ampullary (HR 2.27, P = 0.019) and distal cholangio (HR 1.84, P = 0.025) cancer, as well as a decrease in OS for distal cholangio (HR 1.71, P = 0.045) and duodenal cancer (HR 4.59, P \u003C 0.001) was found in the MIPD group.  \nConclusions This individual patient data meta-analysis of MIPD versus OPD in patients with NPPC suggests that MIPD isnot inferior in terms of short-term morbidity and mortality. Several major limitations in long-term data highlight a research gap that should be studied in prospective maintained international registries or randomized studies for ampullary, distal cholangio, and duodenum cancer separately.  \nProtocol registration PROSPERO (CRD42021277495) on the 25th of October 2021.  \nKeywords Minimally invasive surgery · Minimally invasive pancreatoduodenectomy · Ampulla of Vater carcinoma · Duodenal adenocarcinoma · Distal cholangiocarcinoma · Individual patient data meta-analysis  \nAbbreviations  \nAJCC American Joint Committee on Cancer ASA American Society of Anesthesiologists  \nRenyi Qin, Marc G. Besselink, and Mohammed Abu Hilal are shared senior authors.  \nExtended author information available on the last page of the article  \nDFS  \nDGE  \nHR  \nIPDMA IQR  \nMD  \nMIPD  \nNPPC  \nDisease-free survival  \nDelayed gastric emptying  \nHazard ratio  \nIndividual Patient Data Meta-Analysis Inter quartile range  \nMead difference  \nMinimally invasive pancreatoduodenectomy Non-pancreatic periampullary cancer  \nOPD Open pancreatoduodenectomy  \nOS Overall survival  \nPD Pancreatoduodenectomy  \nPDAC Pancreatic ductal adenocarcinoma POPF Postoperative pancreatic fistula PPH Postpancreatectomy hemorrha","cbCaiotq4tRLFtqU","https://ap.wps.com/l/cbCaiotq4tRLFtqU","pdf",1914212,15,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n# Introduction\n## Periampullary cancer and NPPC heterogeneity\n## Treatment and rationale for MIPD vs OPD","[{\"question\":\"What question does this meta-analysis address?\",\"answer\":\"It assesses the clinical implications of minimally invasive pancreatoduodenectomy versus open pancreatoduodenectomy in patients with non-pancreatic periampullary cancer, including subgroup effects.\"},{\"question\":\"How was the evidence collected for the analysis?\",\"answer\":\"A systematic review searched Pubmed, Embase, and Cochrane databases, and individual patient data were required from all included studies comparing MIPD and OPD for NPPC between 01/2015 and 12/2021.\"},{\"question\":\"Which outcomes were compared between MIPD and OPD?\",\"answer\":\"The study compared 90-day mortality and major morbidity (Clavien-Dindo 3a–5), and also evaluated postoperative pancreatic fistula, delayed gastric emptying, postpancreatectomy hemorrhage, blood loss, length of hospital stay, and overall survival.\"}]","The clinical implication of minimally invasive versus open pancreatoduodenectomy for non-pancreatic periampullary cancer - a systematic review and individual patient data meta-analysis | PDF",1790260365,38]