Trial reportThe British journal of surgery2019
Costs and quality of life in a randomized trial comparing minimally invasive and open distal pancreatectomy (LEOPARD trial).
Trial report in The British journal of surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 55 citations in OpenAlex.
- Systematic review and meta-analysis of cost-effectiveness of minimally invasive versus open pancreatic resections.Langenbeck's archives of surgery · 2023Pooled it
- Feasibility and safety of laparoscopic small bowel resections with intracorporal anastomosis in emergency settings - a retrospective single centre study.Langenbeck's archives of surgery · 2026Article
- Is Kangduo robotic distal pancreatectomy more economically efficient and effective in postoperative outcomes compared to laparoscopic surgery? A propensity-matched analysis.Journal of robotic surgery · 2025Article
- Review
- Clinical outcomes and cost-effectiveness analysis of robotic and endoscopic cooperative surgery for treating gastric submucosal tumors: a longitudinal nested cohort study.Surgical endoscopy · 2025Article
- Laparoscopic pancreatic enucleation: how far should we go for parenchyma preservation? A study by the French National Association of Surgery.Surgical endoscopy · 2025Article
- Cost-effectiveness of open versus laparoscopic pancreaticoduodenectomy: a retrospective Markov model analysis from China.Frontiers in oncology · 2025Article
- Cost-effectiveness of robotic vs laparoscopic distal pancreatectomy. Results from the national prospective trial ROBOCOSTES.Surgical endoscopy · 2024Observational
- Nationwide cost-effectiveness and quality of life analysis of minimally invasive distal pancreatectomy.Surgical endoscopy · 2024Article
- What defines the "value" of robotic surgery for patients with gastrointestinal cancers? Perspectives from a U.S. Cancer Center.Annals of gastroenterological surgery · 2024Review
- Quality of life after pancreatic surgery.World journal of gastroenterology · 2024Review
- Recovery of health-related quality of life after laparoscopic versus open distal pancreatectomy.Surgical endoscopy · 2024Article
- Analysis of long-term outcomes after minimally invasive spleen-preserving distal pancreatectomy under the 'Kimura-first' strategy.Journal of minimal access surgery · 2024Article
- Evaluation of factors predicting loss of benefit provided by laparoscopic distal pancreatectomy compared to open approach.Updates in surgery · 2022Article
- Minimally invasive (laparoscopic and robot-assisted) versus open approach for central pancreatectomies: a single-center experience.Surgical endoscopy · 2022Article
- Laparoscopic versus open distal pancreatectomy: a single centre propensity score matching analysis.Updates in surgery · 2021Article
- The experience of the minimally invasive (MI) fellowship-trained (FT) hepatic-pancreatic and biliary (HPB) surgeon: could the outcome of MI pancreatoduodenectomy for peri-ampullary tumors be better than open?Surgical endoscopy · 2021Article
- Perioperative and oncologic outcomes of open, laparoscopic, and robotic distal pancreatectomy for pancreatic adenocarcinoma.Updates in surgery · 2021Article
- Cost-effectiveness and quality of life analysis of laparoscopic and robotic distal pancreatectomy: a propensity score-matched study.Surgical endoscopy · 2021Article
- Essential updates 2018/2019: Current topics in the surgical treatment of pancreatic ductal adenocarcinoma.Annals of gastroenterological surgery · 2021Review
Corrections and comments
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Authors and funding
11 authors at 12 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMinimally invasive distal pancreatectomy decreases time to functional recovery compared with open distal pancreatectomy, but the cost-effectiveness and impact on disease-specific quality of life have yet to be established.
methodsThe LEOPARD trial randomized patients to minimally invasive (robot-assisted or laparoscopic) or open distal pancreatectomy in 14 Dutch centres between April 2015 and March 2017. Use of hospital healthcare resources, complications and disease-specific quality of life were recorded up to 1 year after surgery. Unit costs of hospital healthcare resources were determined, and cost-effectiveness and cost-utility analyses were performed. Primary outcomes were the costs per day earlier functional recovery and per quality-adjusted life-year.
resultsAll 104 patients who had a distal pancreatectomy (48 minimally invasive and 56 open) in the trial were included in this study. Patients who underwent a robot-assisted procedure were excluded from the cost analysis. Total medical costs were comparable after laparoscopic and open distal pancreatectomy (mean difference €-427 (95 per cent bias-corrected and accelerated confidence interval €-4700 to 3613; P = 0·839). Laparoscopic distal pancreatectomy was shown to have a probability of at least 0·566 of being more cost-effective than the open approach at a willingness-to-pay threshold of €0 per day of earlier recovery, and a probability of 0·676 per additional quality-adjusted life-year at a willingness-to-pay threshold of €80 000. There were no significant differences in cosmetic satisfaction scores (median 9 (i.q.r. 5·75-10) versus 7 (4-8·75); P = 0·056) and disease-specific quality of life after minimally invasive (laparoscopic and robot-assisted procedures) versus open distal pancreatectomy.
conclusionLaparoscopic distal pancreatectomy was at least as cost-effective as open distal pancreatectomy in terms of time to functional recovery and quality-adjusted life-years. Cosmesis and quality of life were similar in the two groups 1 year after surgery.
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