Total Laparoscopic Pancreaticoduodenectomy

Abstract

Total laparoscopic pancreaticoduodenectomy may be a viable alternative to the standard Whipple procedure, offering the potential of a decreased length of stay, quick recovery, and improved quality of life.

Early National Experience with Laparoscopic Pancreaticoduodenectomy for Ductal Adenocarcinoma: A Comparison of Laparoscopic Pancreaticoduodenectomy and Open Pancreaticoduodenectomy from the National Cancer Data Base

“…Smaller longitudinal series examining outcomes for LPD but not directly comparing LPD with OPD have noted rates of margin-negative resection, lymph node harvest, pancreatic fistula rates, and perioperative mortality rates to be comparable with those of OPD that are reported in the literature. [7][8][9][10]17,18 Some have also demonstrated a potential benefit to LPD with regard to initial LOS. [13][14][15][17][18][19] In the current study, we have attempted to improve on these single-institution series by examining outcomes from a large national database.…”

“…The reported national experience with LPD to date consists primarily of case reports or small, singleinstitutional series with <25 evaluated procedures. [6][7][8][9][10][11][12] There have been very few reports examining outcomes of LPD specifically for ductal adenocarcinoma of the pancreatic head (PDCA) and similarly, even fewer studies comparing outcomes for LPD and open pancreaticoduodenectomy (OPD) for pancreatic head cancers. [13][14][15] As a result, substantial evidence supporting the oncologic equivalence of the laparoscopic approach to the established standard of OPD is lacking.…”

Long-sleeve-working-port assisted laparoscopic pancreaticoduodenectomy—A new technique in laparoscopic surgery

“…Since then, LPD has been reported from some specialized centers [5], [6]. Technical difficulties in LPD have made this operation very challenging, even to experienced laparoscopic surgeons, and this operation cannot be popularized [7], [8], [9], [10], [11].…”

Relationship between post-operative cognitive dysfunction and regional cerebral oxygen saturation and β-amyloid protein

“…Laparoscopic pancreaticoduodenectomy is one of the mostly reported and "popular" laparoscopic pancreatic surgical procedures, which may offer many benefits to patients, such as shorter length of hospital stay, fewer complications, and improved quality of life, but the average operative time is up to 10 h. The incidence of POCD after operation is also high (Jacobs and Kamyab, 2013;Mesleh et al, 2013). This may be associated with hypercarbia induced by the long duration of pneumoperitoneum and CO 2 absorption through the peritoneum.…”

“…However, it also has some shortcomings; for example, compared with a conventional operation, its average operation time is up to 10 h, average blood loss 139 ml, post-operation hospitalization time up to 6.6 d (Jacobs and Kamyab, 2013;Mesleh et al, 2013), and the incidence of cognitive dysfunction is higher than that of other abdominal surgery. It might have a strong relationship with operation time and anesthesia management.…”