Is total laparoscopic pancreaticoduodenectomy superior to open procedure? A meta-analysis

Table 3 Meta-analysis of oncological outcomes

Outcome of interest	No. of studies	Sample size		Heterogeneity		Model	Overall effect size	95%CI of overall effect	P-value
		TLPD	OPD	P	I2
Tumor size	10	814	4782	< 0.00001	85%	R	WMD = -0.32	-0.58, -0.07	0.01
RLNs	12	1600	12347	< 0.00001	77%	R	WMD = 1.32	0.57, 2.06	0.0005
R0 rate	19	1991	14477	0.88	0	F	OR = 1.28	1.13, 1.44	0.0001
Time to adjuvant chemotherapy	2	867	7526	0.39	0	F	WMD = -2.44	-4.39, -0.49	0.01
RFS of all malignant tumor patients
1-yr RFS	2	52	37	NA	NA	F	OR = 0.44	0.16, 1.23	0.12
3-yr RFS	2	52	37	0.22	35%	F	OR = 0.53	0.19, 1.47	0.22
5-yr RFS	2	52	37	0.31	4%	F	OR = 0.40	0.12, 1.33	0.14
OS of all malignant tumor patients
1-yr OS	5	412	2206	0.007	72%	R	OR = 0.62	0.33, 1.19	0.15
2-yr OS	4	400	2194	0.03	66%	R	OR = 0.61	0.32, 1.17	0.14
3-yr OS	5	412	2206	0.08	51%	R	OR = 0.80	0.40, 1.62	0.54
4-yr OS	4	400	2194	0.60	0	F	OR = 0.73	0.41, 1.30	0.28
5-yr OS	6	520	2420	0.52	0	F	OR = 0.78	0.38, 1.59	0.49
OS of PDAC patients
1-yr OS	3	349	1947	0.28	22%	F	OR = 0.93	0.74, 1.18	0.57
2-yr OS	3	349	1947	0.21	37%	F	OR = 0.93	0.70, 1.24	0.63
3-yr OS	3	349	1947	0.60	0	F	OR = 0.86	0.56, 1.34	0.52
4-yr OS	3	349	1947	0.95	0	F	OR = 0.97	0.49, 1.92	0.94
5-yr OS	3	349	1947	0.27	17%	F	OR = 0.65	0.19, 2.23	0.49
OS of periampullary adenocarcinoma patients
1-yr OS	3	349	1947	0.28	22%	F	OR = 0.93	0.74, 1.18	0.57
2-yr OS	3	349	1947	0.21	37%	F	OR = 0.93	0.70, 1.24	0.63
3-yr OS	3	349	1947	0.60	0	F	OR = 0.86	0.56, 1.34	0.52
4-yr OS	3	349	1947	0.95	0	F	OR = 0.97	0.49, 1.92	0.94
5-yr OS	3	349	1947	0.27	17%	F	OR = 0.65	0.19, 2.23	0.49
5-yr OS	6	520	2420	0.52	0	F	OR = 0.78	0.38, 1.59	0.49

RLNs: Retrieved lymph nodes; RFS: Recurrence-free survival; OS: Overall survival; PDAC: Pancreatic ductal adenocarcinoma; OR: Odds Ratio; CI: Confidence interval; F: Fixed-effects model; R: Random-effects model; NA: Not applicable; TLPD: Total laparoscopic pancreaticoduodenectomy; OPD: Open pancreaticoduodenectomy.