Laparoscopic Pancreaticoduodenectomy: Technique and Outcomes

Palanivelu, C.; Jani, Kalpesh; Senthilnathan, Palanisamy; Parthasarathi, R.; Rajapandian, Subbiah; Madhankumar, Madathupalayam Velusamy

doi:10.1016/j.jamcollsurg.2007.04.004

Cited by 230 publications

(179 citation statements)

References 19 publications

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“…However, these patients may benefit the most from the minimally invasive approaches if they can be done safely. The earliest series of MIPD involved patients with small [39][40][41] , benign or low grade [38,41,42] tumours of the pancreatic head, duodenal ampulla, and distal common bile duct, in the absence vascular or extrabiliary involvement [39,40,42,43] . Patients with ampullary lesions, mucinous cystic neoplasms and Intrapapillary Mucinous Neoplasms (IPMNs) are ideal surgical candidates for MIPD due to the tendency for them to be non-adherent to the major arterial and venous structures near the pancreatic neck and uncinate process.…”

Section: Patient Selectionmentioning

confidence: 99%

“…Several retrospective series demonstrate that MIPD can be safely performed in experienced hands. The average operating time and blood loss for three large MIPD series are 368-541 min, and 65-240 cc, respectively [35,41,43] . In comparison, a contemporary OPD series by Cho et al [38] shows that the average operating time is shorter (287 min), and blood loss is greater (552 cc) in open cases.…”

Section: Minimally Invasive Pancreaticoduodenectomymentioning

confidence: 99%

“…Most MIPD series report low mortality rate [38][39][40][41][42][43][44][45][46] ; Gumbs et al [48] reviewed 285 cases and found the overall mortality was 2%. A more recent series reports a 100-d mortality rate of 5.7%, which is not significantly different than the mortality rate of 8.8% in the OPD group in the same series [35] .…”

Section: Post-operative Recoverymentioning

confidence: 99%

“…majority of series. the rate of International Study Group of Pancreatic Fistula (ISGPF) grade B pancreatic fistula ranges from 2.4%-18% [35,38,40,41,43] . Cho et al [38] and Asbun and Stauffer [35] compared their MIPD to contemporary OPD, and found that the OPD group have similar rate of pancreatic fistula (3%-13%).…”

Section: Post-operative Recoverymentioning

confidence: 99%

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Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and shortterm oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve. Key words: Laparoscopy; Distal pancreatectomy; Pancreaticoduodenectomy; Robotic pancreatectomy; Enucleation Core tip: This review discusses recent advances in laparoscopic distal pancreatectomy (LDP), minimally invasive pancreaticoduodenectomy (MIPD), and enucleation. Recent studies show that LDP have improved perioperative recovery and equivalent oncologic outcomes. Studies on MIPD demonstrate that it is safe in terms of intra-operative outcomes, post-operative recovery and early oncologic outcomes; however, it requires advanced laparoscopic skills. Laparoscopic enucleation has become the operation of choice for small benign tumours that are away from the main pancreatic duct, especially insulinomas. We also summarize key results in pre-operative, perioperative and post-operative outcomes from contemporary series comparing open and laparoscopic pancreatic resections in the tables.

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Section: Patient Selectionmentioning

confidence: 99%

Section: Minimally Invasive Pancreaticoduodenectomymentioning

confidence: 99%

Section: Post-operative Recoverymentioning

confidence: 99%

Section: Post-operative Recoverymentioning

confidence: 99%

See 2 more Smart Citations

Laparoscopic pancreatectomy: Indications and outcomes

Liang

Hameed

Jayaraman

2014

WJG

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“…[3] We reported our initial experience of LPD in 42 patients in 2007 followed by large series of 75 patients in 2009. [4,5] A review of literature on LPD worldwide by Gagner et al in 2009 reported outcomes of 146 patients. The mean operating time was 439 min, average blood loss of 143 mL; median hospital stay of 18 days; and mortalities related to the procedure was 1.3 % and a complication rate of 16 %.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD. A prospective database of all patients who underwent standard pancreaticoduodenectomy from Mar 2006 to Feb 2011 was taken up for this study. 45 patients who underwent LPD and 118 patients who underwent OPD for periampullary and pancreatic head malignancy were taken up for analysis. The study groups were comparable in terms of age of presentation, ASA grades, comorbidity, type of surgery and BMI. There was no statistically significant difference with regard to tumor size, lymph node yield, node positivity rates, R1 rates and margin lengths. The pathological radicality of laparoscopic pancreaticoduodenectomy is comparable with that of open approach when performed by experienced minimal-access surgeons. Standardized protocols for evaluation of the resection margins should be mandatory in studies reporting outcomes of pancreaticoduodectomy.

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