ArticleInternational journal of surgery (London, England)2026
Does minimally invasive pylorus-preserving pancreaticoduodenectomy (MI-PPPD) triumph over open pylorus-preserving pancreaticoduodenectomy (O-PPPD)? A systematic review and meta-analysis.
Article in International journal of surgery (London, England), 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Who cites it
1 citing paper in PubMed.
- Quality and reliability of pancreaticoduodenectomy-related videos on TikTok, Bilibili, and YouTube: a cross-sectional content analysis.Frontiers in surgery · 2026Article
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8 authors.
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Abstract
backgroundPPPD is purported to be better than the Whipple procedure as it preserves full gastric capacity. Approaching this surgery using the MIS technique [minimally invasive pylorus-preserving pancreaticoduodenectomy (MI-PPPD)] may confer additional advantages compared to the open method. However, literature comparing MI-PPPD to open pylorus-preserving pancreaticoduodenectomy (O-PPPD) is scarce. This study seeks to review the efficacy and long-term outcomes of MI-PPPD against O-PPPD. MATERIALS AND
methodsThis PRISMA-adherent review involved a systematic search of PubMed, Scopus, Cochrane, and Embase for studies evaluating the outcomes of MI-PPPD compared to O-PPPD. Two independent reviewers extracted the summary data from included studies. Random effects meta-analyses were used for analysis. All analyses were performed in RStudio (Posit Software, PBC, Boston, Massachusetts) Version 4.3.2. Artificial intelligence was not used for research and manuscript development.
resultsNine articles with 682 patients (391 in the MI-PPPD group and 291 in the O-PPPD group) were included. Postoperatively, there was no statistically significant differences in postoperative complications [risk ratio (RR) = 1.00, 95% CI: 0.69; 1.46], length of hospital stay [mean difference (MD) = -0.21, 95% CI: -0.53; 0.11], postoperative pancreatic fistula formation (RR = 0.78, 95% CI: 0.59; 1.05), delayed gastric emptying (RR = 0.63, 95% CI: 0.35; 1.14), postpancreatectomy hemorrhage (RR = 1.38, 95% CI: 0.77; 2.46), and 90-day mortality (RR = 2.42, 95% CI: 0.92; 6.34). Perioperatively, MI-PPPD had nonsignificant reduction in estimated blood loss (MD = -129.07, 95% CI: -579.35; -312.20) and nonsignificant difference in operative time (MD = 0.38 min, 95% CI: -0.18; 0.95). Oncological outcomes revealed equivalent outcomes in R0 resection (MD = 0.50%, 95% CI: 0.07; 3.82) and lymph node yield (MD = -1.31, 95% CI: -2.83; 0.22).
conclusionMI-PPPD is noninferior to O-PPPD. Whilst MI-PPPD outcomes have been influenced by its high complexity and steep learning curve, this approach is believed to be on an upwards trajectory with the potential to surpass O-PPPD. Investment toward MI-PPPD training is recommended given the potential benefits it brings to patients.
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