Systematic Review of Minimally Invasive Pancreatic Resection

Abstract

Laparoscopic distal pancreatic resection and enucleation of insulinoma appear to be safe procedures with reduced hospital stay, though morbidity remains significant. The evidence for laparoscopic pancreaticoduodenectomy is in its infancy, but the authors feel it is unlikely that many centers will achieve sufficient case load to make the introduction of minimally invasive resection feasible.

Distal pancreatic resection via laparo-endoscopic single site surgery – development of the technique

“…The authors also found no difference between open and laparoscopic approach with regard to the operative times, frequency of perioperative morbidity and mortality, and treatment costs. Further comparative studies and systematic reviews proved the laparoscopic approach to be superior also in terms of shorter operative times and decreased blood loss [7,8].…”

Laparoscopic pancreatic resection—a review

“…Spleen preserving LDP has been described to be safe and feasible (10,22) and has been reported in 18.2% (16) to 60.4% (31) of LDPs.…”

The Current State of Minimally Invasive Distal Pancreatectomy

“…The feasibility of laparoscopic pancreatic surgery was first documented in numerous case series largely conducted at single institutions [4][5][6][7][8][9][10][11][12][13][14][15][16][17]. As familiarity developed, significant experiences were reported.…”

“…As familiarity developed, significant experiences were reported. Naturally, higher-volume centers have offered direct comparisons of laparoscopic and open outcomes [6,7,11,14,16,[21][22][23][24][25][26][27]. Over the past year, five reports have advanced this literature by pooling such studies using meta-analytical techniques [28, 29 • , 30, 31, 32 • ].…”

“…The approach has several potential technical advantages over open resection, including better visualization and exposure of the pancreas within the retroperitoneum. Since its inception, multiple studies have documented the safety and feasibility of the laparoscopic approach [4][5][6][7][8][9][10][11][12][13][14][15][16][17], and several reports have chronicled initial experiences with robotic distal pancreatectomy (RDP) as well [18][19][20]. Minimally invasive distal pancreatectomy (MIDP; encompassing LDP and RDP) is steadily becoming more widespread, and with accrued experience, increasingly complex lesions are being approached.…”