Minimally Invasive Versus Open Pancreatoduodenectomy

Abstract

Outcomes after MIPD seem promising in comparative cohort studies, despite the presence of bias, whereas registry studies report higher mortality in low-volume centers. The introduction of MIPD should be closely monitored and probably done only within structured training programs in high-volume centers.

Randomized clinical trial of laparoscopicversusopen pancreatoduodenectomy for periampullary tumours

“…Laparoscopic pancreatoduodenectomy, although technically difficult and requiring a high degree of expertise, has shown efficacy equal to that of open pancreatoduodenectomy in terms of complications, oncological safety and overall outcomes, with inherent advantages of minimally invasive surgery such as decreased blood loss, reduced pain, shorter hospital stay and earlier return to work. Although a recent study from a high‐volume centre reported concerns about greater morbidity for the laparoscopic approach, with a higher pancreatic fistula rate, a meta‐analysis including more than 20 000 patients revealed favourable outcomes in well selected patients in centres with a larger volume.…”

Minimally invasive surgical treatment of carcinoma of the papilla of Vater: A case report

“…A sufficient extent of surgical resection and lymphadenectomy can be achieved by laparoscopic access, as proved by the pathological examination of the resection specimen showing a sufficient number of lymph nodes resected and negative resection margins. Blood loss was significantly lower compared to conventional methods (11,12). Operating time was slightly longer with laparoscopic procedures compared to the classical method and the number of post-operative days is lower in the laparoscopic compared to the conventional surgery (13).…”

Minimally invasive pancreatic surgery—where are we going?

“…Systematic reviews and meta-analyses comparing MIPD and OPD report less intraoperative blood loss, a lower transfusion rate, longer operative time, and shorter hospital stay for the former [42][43][44][45]. The oncologic outcomes were equivalent to those in OPD [41,45].…”