Laparoscopic pancreatic surgery

Park, Adrian; Schwartz, Richard W.; Tandan, Véd; Anvari, Mehran

doi:10.1016/s0002-9610(98)00325-0

Cited by 104 publications

(67 citation statements)

References 30 publications

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“…The main concerns regarding HLAPD are whether smaller incisions are achieved at the expense of the quality of oncologic resection and whether any tangible patient benefit is achieved. 20 For pancreaticoduodenectomy, positive margin rates of 20%-40% have been reported in the literature. 21,22 Recently, a systematic review of 707 patients undergoing laparoscopic pancreaticoduodenectomy reported an R1 resection rate of 42.5%.…”

Section: Discussionmentioning

confidence: 99%

Bridging the gap between open and minimally invasive pancreaticoduodenectomy: the hybrid approach

Wang

Bergman

Piedimonte

et al. 2014

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Background: Minimally invasive pancreatic surgery has evolved rapidly, but total laparoscopic pancreaticoduodenectomy has not been widely adopted owing to its technical complexity. Hybrid laparoscopy-assisted pancreaticoduodenectomy (HLAPD) combines the relative ease of open surgery with the benefits of a minimally invasive approach. This study evaluates the safety and effectiveness of the hybrid approach compared with open surgery. Methods:We retrospectively analyzed data of consecutive patients undergoing either hybrid or open pancreaticoduodenectomy (OPD) at our institution between September 2009 and December 2013. Demographic, operative and oncologic data were collected to compare outcomes between HLAPD and OPD.Results: Our analysis included 33 patients (HLAPD: n = 13; OPD: n = 20). There were no differences in patient demographics, comorbidities or surgical indications. The HLAPD group had significantly lower intraoperative blood loss (450 mL v. 1000 mL, p = 0.023) and shorter length of hospital stay (8 v. 12 d, p = 0.025) than the OPD group. Duration of surgery did not differ significantly between the groups. There were no differences in postoperative analgesic requirements, Clavien grade I/II or grade III/IV complications or 90-day mortality. Oncologic outcomes showed no significant differences in tumour size, R1 resection rate or number of lymph nodes harvested. Conclusion:In select patients, HLAPD is a safe and effective procedure with comparable outcomes to conventional open surgery. Wider adoption of the hybrid approach will allow a greater number of patients to benefit from a less invasive procedure while facilitating the transition toward purely minimally invasive pancreaticoduodenectomy.Contexte : La chirurgie pancréatique minimalement effractive a rapidement évolué, mais la pancréatoduodénectomie laparoscopique totale n'a pas été largement adoptée en raison de sa complexité technique. La pancréatoduodénectomie hybride sous laparoscopie (PDHL) allie la relative facilité de la chirurgie ouverte aux avantages d'une approche minimalement effractive. Cette étude compare l'innocuité et l'efficacité de l'approche hybride à celles de la chirurgie ouverte.Méthodes : Nous avons analysé de manière rétrospective les données concernant des patients consécutifs soumis à une pancréatoduodénectomie hybride ou ouverte (PDO) dans notre établissement entre septembre 2009 et décembre 2013. Les données démographiques, opératoires et oncologiques ont été recueillies pour comparer les résultats entre la PDHL et la PDO.

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Section: Discussionmentioning

confidence: 99%

Bridging the gap between open and minimally invasive pancreaticoduodenectomy: the hybrid approach

Wang

Bergman

Piedimonte

et al. 2014

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“…The role of laparoscopy in staging and diagnosis of pancreatic disease did not emerge for another 60 years. [3][4][5] The advance to therapeutic solid-organ laparoscopy has only recently occurred.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Laparoscopy of the Pancreas

Park¹,

Heniford²

2002

Annals of Surgery

182

146

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ObjectiveTo communicate results of laparoscopic treatment of pancreatic pseudocyst (PP) and resection of benign lesions of the pancreas. Perioperative data, surgical outcomes, techniques and insights from 54 cases are presented. Summary Background DataAlthough laparoscopic therapy for other solid organs has been widely adopted, reports of therapeutic laparoscopy of the pancreas have been few and of limited numbers, and its role in pancreatic disease is still unclear. MethodsEighteen men and 11 women were selected for laparoscopic PP surgery. Four distinct laparoscopic approaches were used. An additional 9 men and 16 women underwent laparoscopic distal pancreatectomy (LDP) using a technique similar to the lesser sac approach.

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“…10 With the advent of laparoscopy drainage of the pancreatic pseudocyst by laparoscope began. 6,8,9,11 Up to 2016 more than 250 laparoscopic drainage procedures for pancreatic pseudocyst were performed worldwide with mortality rate 0% success rate 92%, overall complication rate 9%,6.7% conversion to open surgery and recurrence rate 3%.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,6,7 Laparoscopic internal drainage of pancreatic pseudocyst includes a variety of technique such as posterior cystogastrostomy, anterior cystogastrostomy and Rouxen-Y jejunal loop. 8,9 The objective of this study was to evaluate the outcome of pancreatic cystogastrostomy for pancreatic pseudocyst as regard operative and postoperative results in Sohag university Hospitals.…”

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confidence: 99%

Laparoscopic cysto-gastrostomy for management of pancreatic pseudocyst. Single center experience in upper Egypt

2017

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INTRODUCTIONOne of the most common lumps of the pancreas is the pancreatic pseudocyst, with an estimated incidence of 70-80%.1 Pancreatic pseudocyst development following an attack of acute pancreatitis, chronic pancreatitis or abdominal trauma.2 There are two main option for treatment pancreatic pseudocyst if it persists beyond six ABSTRACT Background: One of the most common lumps of the pancreas is the pancreatic pseudocyst, with an estimated incidence of 70-80%. There are two main options for treatment pancreatic pseudocyst if it persists beyond six weeks and not respond to conservative treatment, surgical (laparoscopic and conventional open surgery) and non-surgical treatment (endoscopic and percutaneous drainage through ultrasonography or computed tomography guide). The objective of this study was to evaluate the outcome of laparoscopic pancreatic cystogastrostomy for pancreatic pseudocyst as regard operative and postoperative results in Sohag university Hospitals. Methods: This was a prospective observational single center study at the General surgery department Sohag University Hospitals, Egypt. The study populations were patients suffering from pancreatic pseudocyst attend to the outpatient clinic from March 2014 to March 2017. All patients were evaluated by history taking, physical examination, laboratory investigation and imaging evaluation by abdominal ultrasonography and contrast enhanced computed tomography of the abdomen. Results: Between March 2014 and March 2017, 14 patients with pancreatic pseudocyst had fulfilled our inclusion criteria and included in this study. 8 patients were female and 6 patients were male. 12 patients had previous history of acute biliary pancreatitis at least 6 months before the operation. 2 patient had undetermined pancreatitis. The mean age of the patient was 45.5±1.8 years and the mean operative time was 153±29 minutes the mean time to start oral fluid was 29±2 hours. 12 of the patient shad a laparoscopic cholecystectomy as all of them had acute biliary pancreatitis all operations were completed laparoscopically no conversion to open surgery was done.no mortality detected in our study .no intraoperative complications only one case had postoperative bleeding that respond to conservative therapy, one case of postoperative wound infection responds to antibiotic therapy. All cysts were resolved completely success rate (100%). The mean hospital stay was 4.35±0.28 days. The mean follows up time was 10.5±0.875 months. Conclusions: Laparoscopic cysogastrotomy is as safe, effective procedure for management of the pancreatic pseudocyst in the hand of expert well trained laparoscopic with enough equipment.

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Laparoscopic pancreatic surgery

Cited by 104 publications

References 30 publications

Bridging the gap between open and minimally invasive pancreaticoduodenectomy: the hybrid approach

Bridging the gap between open and minimally invasive pancreaticoduodenectomy: the hybrid approach

Therapeutic Laparoscopy of the Pancreas

Laparoscopic cysto-gastrostomy for management of pancreatic pseudocyst. Single center experience in upper Egypt

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