Laparoscopic Pylorus-Preserving Pancreatoduodenectomy with Double Jejunal Loop Reconstruction: An Old Trick for a New Dog

Machado, Marcel Autran; Makdissi, Fábio F.; Surjan, Rodrigo C.; Machado, Marcel Cerqueira César

doi:10.1089/lap.2012.0338

Cited by 13 publications

(19 citation statements)

References 18 publications

(20 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, laparoscopic pancreatic operations developed slowly, due to the anatomic complexity, retroperitoneal location, and high post-operative morbidity due mainly to the digestive enzyme-rich secretions it produces (5,6,7,11,19) . Nevertheless, laparoscopic pancreatic resection has been increasingly used for the last decade and more complex operations such as pancreaticoduodenectomy were being progressively added to the surgical armamentarium (9,16) . Our experience with laparoscopic pancreatic resection began in 2001 (13) .…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Machado

Surjan

Goldman

et al. 2013

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives -The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods -All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports.Results -Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions -Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. Pancreaticoduodenectomy. Laparoscopy. development of new instruments more complex laparoscopic procedures were performed such as total pancreatectomy, left pancreatectomy with spleen preservation, resection of uncinate process (15) and pancreatoduodenectomies (16) . The aim of this paper was to review our experience with laparoscopic pancreatic resection over 11-year period. METHODSA retrospective review of a prospectively maintained database was performed. All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were identified. Descriptive data were collected. Preoperative variables included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Pancreatic fistula was Arq Gastroenterol 215

show abstract

Section: Introductionmentioning

confidence: 99%

“…Laparoscopy. development of new instruments more complex laparoscopic procedures were performed such as total pancreatectomy, left pancreatectomy with spleen preservation, resection of uncinate process (15) and pancreatoduodenectomies (16) . The aim of this paper was to review our experience with laparoscopic pancreatic resection over 11-year period.…”

mentioning

confidence: 99%

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Machado

Surjan

Goldman

et al. 2013

Arq. Gastroenterol.

View full text Add to dashboard Cite

show abstract

“…our experience with laparoscopic pancreatic resections began in 2001 with distal pancreatectomy (8) . Similarly as occurred with other authors, improvement of our expertise in advanced laparoscopic surgery has allowed us to perform more complex operations such as central pancreatectomies, pancreatoduodenectomy and resection of uncinate process (9,11) . However, only laparoscopic distal pancreatectomy is considered a gold standard.…”

Section: Discussionmentioning

confidence: 64%

First Single-Port Laparoscopic Pancreatectomy in Brazil

Machado¹,

Surjan²,

Makdissi³

2013

Arq. Gastroenterol.

View full text Add to dashboard Cite

-Context -Pancreatic surgery is an extremely challenging field, and the management of pancreatic diseases continues to evolve. in the past decade, minimal access surgery is moving towards minimizing the surgical trauma by reducing numbers and size of the port. in the last few years, a novel technique with a single-incision laparoscopic approach has been described for several laparoscopic procedures. Objectives -We present a single-port laparoscopic spleen-preserving distal pancreatectomy. To our knowledge, this is the first single-port pancreatic resection in Brazil and latin America. Methods -A 33-year-old woman with neuroendocrine tumor underwent spleen-preserving distal pancreatectomy via single-port approach. A single-incision advanced access platform with gelatin cap, self-retaining sleeve and wound protector was used. Results -operative time was 174 minutes. Blood loss was minimal, and the patient did not receive a transfusion. The recovery was uneventful, and the patient was discharged on postoperative day 4. Conclusions -Single-port laparoscopic spleen-preserving distal pancreatectomy is feasible and can be safely performed in specialized centers by skilled laparoscopic surgeons. HEADINGS -Pancreatectomy. laparoscopy.

show abstract

“…In order to decrease morbidity and mortality, several options have been suggested to avoid the activation of pancreatic juice by biliary secretion and, consequently, to reduce the appearance and severity of a pancreatic fistula [5].…”

Section: Discussionmentioning

confidence: 99%

Double Gastrojejunocolic Fistula as a Late Complication of Pancreatic Head Resection for a Non-Functioning Pancreatic Tumor

Ferroni¹

2014

Pancreat Disord Ther

View full text Add to dashboard Cite

Pancreatic head resection represents one of the most demanding procedures in abdominal surgery; however, several complications may develop after this type of surgery such as fistulas (internal and/or external), gastrointestinal tract hemorrhage, and abdominal infections. The relaparotomy rate, as well as low perioperative mortality, may be present. The reported postoperative complication rate may range from 23 to 57%, even when an expert surgeon performs the resection. However, late complications of pancreatic head resection are rare. A case of double gastrojejunocolic fistula, which developed in a patient who had undergone pancreatic head resection some years earlier, is herein reported. The patient was admitted to our hospital for abdominal pain associated with nausea and vomiting. She also complained of diarrhea after food ingestion, even in small quantities, and referred the presence of undigested food in the feces and a weight loss of 10 kg in the previous three months. The patient was treated conservatively. We should be aware that symptoms of fistulas due to pancreatic head resections may be diagnosed several years after surgery.

show abstract

Laparoscopic Pylorus-Preserving Pancreatoduodenectomy with Double Jejunal Loop Reconstruction: An Old Trick for a New Dog

Abstract: Laparoscopic pylorus-preserving pancreatoduodenectomy with double jejunal loop reconstruction is feasible and may be useful to decrease morbidity and mortality after pancreatoduodenectomy. This operation is challenging and may be reserved for highly skilled laparoscopic surgeons.

Cited by 13 publications

References 18 publications

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

Laparoscopic Pancreatic Resection. From Enucleation to Pancreatoduodenectomy. 11-Year Experience

First Single-Port Laparoscopic Pancreatectomy in Brazil

Double Gastrojejunocolic Fistula as a Late Complication of Pancreatic Head Resection for a Non-Functioning Pancreatic Tumor

Contact Info

Product

Resources

About