Laparoscopic total remnant pancreatectomy after laparoscopic pancreaticoduodenectomy

Sunagawa, Hiroki; Mayama, Yasuaki; Orokawa, Tomofumi; Oshiro, Naoto

doi:10.1111/ases.12064

Cited by 14 publications

(6 citation statements)

References 9 publications

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“…However, in elderly patients who need to undergo pancreaticoduodenectomy, the mortality and morbidity rates were comparable between these two approaches, and LPD might have certain advantages over OPD (116). Similarly, several studies have also shown that LPD is safe and feasible in elderly patients (43,117,118). Topic 14: Follow-up after LPD Statement: Recurrence-free and overall survival after LPD are equal to that after OPD, and both procedures achieve equivalent rates of radical resection margins and number of harvested lymph nodes.…”

Section: Strength Of Recommendation: Strongmentioning

confidence: 99%

International expert consensus on laparoscopic pancreaticoduodenectomy*

Qin¹,

Kendrick²,

Wolfgang³

et al. 2020

Hepatobiliary Surg Nutr

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Importance: While laparoscopic pancreaticoduodenectomy (LPD) is being adopted with increasing enthusiasm worldwide, it is still challenging for both technical and anatomical reasons. Currently, there is no consensus on the technical standards for LPD.Objective: The aim of this consensus statement is to guide the continued safe progression and adoption of LPD.Evidence Review: An international panel of experts was selected based on their clinical and scientific expertise in laparoscopic and open pancreaticoduodenectomy. Statements were produced upon reviewing the literature and assessed by the members of the expert panel. The literature search and its critical appraisal were limited to articles published in English during the period from 1994 to 2019. The Web of Science, Medline, and Cochrane Library and Clinical Trials databases were searched, The search strategy included, but was not limited to, the terms 'laparoscopic', 'pancreaticoduodenectomy, 'pancreatoduodenectomy', 'Whipple's operation', and 'minimally invasive surgery'. Reference lists from the included articles were manually checked for any additional studies, which were included when appropriate. Delphi method was used to establish expert consensus and the AGREE II-GRS Instrument was applied to assess the methodological quality and externally validate the final statements. The statements were further discussed during a one-day face-to-face meeting at the 1 st Summit on Minimally Invasive Pancreatico-Biliary Surgery in Wuhan, China.Findings: Twenty-eight international experts from 8 countries constructed the expert panel. Sixteen statements were produced by the members of the expert panel. At least 80% of responders agreed with the majority (80%) of statements. Other than three randomized controlled trials published to date, most evidences were based on level 3 or 4 studies according to the AGREE II-GRS Instrument. Conclusions and Relevance:The Wuhan international expert consensus meeting on LPD has produced a set of clinical practice statements for the safe development and progression of LPD. LPD is currently in its development and exploration stages, as defined by the international IDEAL framework for surgical innovation. More robust randomized controlled trial and registry study are essential to proceed with the assessment of LPD.

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Section: Strength Of Recommendation: Strongmentioning

confidence: 99%

International expert consensus on laparoscopic pancreaticoduodenectomy*

Qin¹,

Kendrick²,

Wolfgang³

et al. 2020

Hepatobiliary Surg Nutr

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“…Nonetheless, the minimally-invasive approach for CP has been rarely reported and to the best of our knowledge only 2 studies215 reporting on 3 cases have been published to date (Table 1). This is likely due to the combination of: 1) the rarity for the need of CP especially in the elective setting as isolated local recurrence of pancreatic neoplasms are rare and 2) the perceived technical difficulty of the procedure due to the frequent presence of dense adhesions occurring after PD.…”

Section: Discussionmentioning

confidence: 99%

“…This is likely due to the combination of: 1) the rarity for the need of CP especially in the elective setting as isolated local recurrence of pancreatic neoplasms are rare and 2) the perceived technical difficulty of the procedure due to the frequent presence of dense adhesions occurring after PD. Sunagawa et al reported the first laparoscopic CP after previous LPD in 2013 15. The patient developed remnant pancreatic cancer eighteen months after LPD for distal bile duct cancer.…”

Section: Discussionmentioning

confidence: 99%

Robotic assisted laparoscopic completion pancreatectomy for recurrent intraductal papillary mucinous neoplasm after previous open pancreatoduodenectomy: A case report and literature review

Kyaw

Goh

2019

Ann Hepatobiliary Pancreat Surg

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Completion pancreatectomy (CP), is an effective, and potentially curative option for selected patients with local recurrence of pancreatic neoplasms in the remnant pancreas after initial pancreatoduodenectomy (PD). Traditionally CP has been performed via the open approach. Reports of minimally-invasive CP particularly after previous open PD are rare. We present a case of a 72-year old male who previously underwent open PD 5 years ago for intraductal papillary mucinous neoplasm (IPMN) with high grade dysplasia in the uncinate process. He had multifocal IPMN and low-risk lesions in the body and tail were managed conservatively. On routine surveillance, the cyst in the body was noted to be increasing in size with the development of a non-enhancing solid component confirmed on magnetic resonance imaging and subsequent endoscopic ultrasonography. The patient underwent successful robotic assisted laparoscopic completion pancreatectomy. Final histology confirmed a recurrent IPMN with low-to-intermediate grade dysplasia. The postoperative recovery was uneventful and he was discharged on postoperative day 9.

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“…Laparoscopic pancreatectomy was first reported by Gagner and Pomp in 1994 , and since then, there has been a rapid increase in the number of papers reporting the effectiveness of this technique. Most of the reports cite reduced blood loss and shorter hospital stay as the main advantages of laparoscopic pancreatectomy . More recently, a number of meta‐analyses have compared Lap‐DP with laparotomy in terms of surgical outcomes .…”

Section: Discussionmentioning

confidence: 99%