Background: Laparoscopic Whipple’s Pancreatico-duodenectomy (WPD) remains one of the most advanced minimally invasive pancreatic surgical procedure. Laparoscopic WPD has been increasingly adopted as a safe and feasible technique in recent years. This study aimed to compare the short-term outcomes of laparoscopic WPD to open WPD for resectable periampullary and pancreatic cancer.

Material and Methods: The study consisted of are trospective analysis of a prospectively maintained database of patients who underwent WPD from November 2017 to May 2021 at a tertiary care institute in Delhi, India. Patient demographics and preoperative details (age, sex,CA-19-9 levels, jaundice, preoperative stenting), intraoperative parameters, postoperative length of hospital stay, median ICU stay, time to resume oral diet, postoperative complications, interventional procedures,and mortality were analysed.

Results: Of 113 patients who underwent WPD, 67 patients underwent laparoscopic WPD, and 41 patients underwent open WPD. Conversion to open procedure was required in 5 patients. Pancreatic-enteric anastomosis was done using pancreaticogastrostomy (modified double U stitch technique). Laparoscopic WPD was associated with shorter hospital stay (9 vs. 11 days, p<0.001) and a lower incidence of surgical site infection (8.9 vs. 21.9 %, p=0.05) compared to open WPD. Median operating time was longer in the laparoscopy group (360 vs. 300 mins, p<0.001) with a comparable blood loss volume.No significant difference in complications like delayed gastric emptying (14.9 vs. 17 %, p=0.77), postoperative pancreatic fistula (11.9 vs.14.6%, p=0.68), post pancreatic hemorrhage (10.4 vs. 9.7 %, p=0.90), and overall mortality (2.9 vs. 2.4 %, p=0.87) were found between both the groups. R0 resection and median lymph node yield were comparable between the two groups.

Conclusion: Laparoscopic WPD appears to be safe and feasible with similar short-term outcomes and non-inferior early oncological outcomes compared with open WPD.