# Long‐Term Nutritional Benefits of Laparoscopic Pancreatoduodenectomy Over Open Surgery

## TL;DR

Laparoscopic pancreatoduodenectomy (LPD) improves long-term nutrition and recovery compared to traditional open surgery.

## Contribution

This study demonstrates that LPD preserves muscle mass and reduces fatty liver incidence better than open PD in the long term.

## Key findings

- LPD patients had better psoas muscle index (PMI) preservation at 12 months compared to open PD patients.
- LPD was associated with lower fatty liver incidence and higher nutritional index values at 3 months.
- LPD reduced blood loss and hospital stays while improving postoperative nutritional status.

## Abstract

Pancreatoduodenectomy (PD) is a highly invasive surgical procedure associated with postoperative malnutrition. Laparoscopic pancreatoduodenectomy (LPD) is a minimally invasive alternative, but its long‐term effects on nutritional outcomes remain unclear. This study aimed to compare long‐term nutritional outcomes between LPD and open PD (OPD) and to identify factors influencing postoperative nutritional status.

A retrospective analysis was conducted on 65 patients who underwent PD. Nutritional indicators, including the psoas muscle index (PMI), prognostic nutritional index, and liver‐to‐spleen ratio, were assessed at 3, 6, and 12 months postoperatively. Multivariate analysis was performed to determine factors affecting nutritional outcomes.

The LPD group (n = 36) demonstrated better PMI preservation at 12 months compared with the OPD group (n = 29) (p = 0.002), with significantly lower fatty liver incidence (3.7% vs. 22.7%, p = 0.038) and higher prognostic nutritional index values at 3 months (p = 0.029). LPD was identified as an independent factor for improved PMI (p = 0.020). Additionally, LPD was associated with reduced blood loss and shorter hospital stays.

LPD improves long‐term nutritional outcomes by preserving muscle mass and reducing metabolic disruptions, thus supporting its role in enhancing postoperative recovery and quality of life. Further prospective studies are warranted to confirm these findings.

Minimally invasive laparoscopic pancreaticoduodenectomy (LPD) significantly improves long‐term nutritional outcomes compared to open pancreaticoduodenectomy (OPD). LPD patients demonstrated better preservation of muscle mass index (PMI) and a lower incidence of postoperative fatty liver. The reduced surgical trauma associated with LPD contributed to enhanced postoperative nutritional status and quicker recovery.