BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD) is gaining momentum, but there is still uncertainty regarding its safety, reproducibility, and oncologic appropriateness. This review assesses the current status of LPD. METHODS: Our literature review was conducted in Pubmed. Articles written in English containing five or more LPD were selected. RESULTS: Twenty-five articles matched the review criteria. Out of a total of 746 LPD, 341 were reported between 1997 and 2011 and 405 (54.2 %) between 2012 and June 1, 2013. Pure laparoscopy (PL) was used in 386 patients (51.7 %), robotic assistance (RA) in 234 (31.3 %), laparoscopic assistance (LA) in 121 (16.2 %), and hand assistance in 5 (0.6 %). PL was associated with shorter operative time, reduced blood loss, and lower rate of pancreatic fistula (vs LA and RA). LA was associated with shorter operative time (vs RA), but with higher blood loss and increased incidence of pancreatic fistula (vs PL and RA). Conversion to open surgery was required in 64 LPD (9.1 %). Operative time averaged 464.3 min (338-710) and estimated blood 320.7 mL (74-642). Cumulative morbidity was 41.2 %, and pancreatic fistula was reported in 22.3 % of patients (4.5-52.3 %). Mean length of hospital stay was 13.6 days (7-23), showing geographic variability (21.9 days in Europe, 13.0 days in Asia, and 9.4 days in the US). Operative mortality was 1.9 %, including one intraoperative death. No difference was noted in conversion rate, incidence of pancreatic fistula, morbidity, and mortality when comparing results from larger (≥30 LPD) and smaller (≤29 LPD) series. Pathology demonstrated ductal adenocarcinoma in 30.6 % of the specimens, other malignant tumors in 51.7 %, and benign tumor/disease in 17.5 %. The mean number of lymph nodes examined was 14.4 (7-32), and the rate of microscopically positive tumor margin was 4.4 %. CONCLUSIONS: In selected patients, operated on by expert laparoscopic pancreatic surgeons, LPD is feasible and safe.
BACKGROUND: Laparoscopic pancreaticoduodenectomy (LPD) is gaining momentum, but there is still uncertainty regarding its safety, reproducibility, and oncologic appropriateness. This review assesses the current status of LPD. METHODS: Our literature review was conducted in Pubmed. Articles written in English containing five or more LPD were selected. RESULTS: Twenty-five articles matched the review criteria. Out of a total of 746 LPD, 341 were reported between 1997 and 2011 and 405 (54.2 %) between 2012 and June 1, 2013. Pure laparoscopy (PL) was used in 386 patients (51.7 %), robotic assistance (RA) in 234 (31.3 %), laparoscopic assistance (LA) in 121 (16.2 %), and hand assistance in 5 (0.6 %). PL was associated with shorter operative time, reduced blood loss, and lower rate of pancreatic fistula (vs LA and RA). LA was associated with shorter operative time (vs RA), but with higher blood loss and increased incidence of pancreatic fistula (vs PL and RA). Conversion to open surgery was required in 64 LPD (9.1 %). Operative time averaged 464.3 min (338-710) and estimated blood 320.7 mL (74-642). Cumulative morbidity was 41.2 %, and pancreatic fistula was reported in 22.3 % of patients (4.5-52.3 %). Mean length of hospital stay was 13.6 days (7-23), showing geographic variability (21.9 days in Europe, 13.0 days in Asia, and 9.4 days in the US). Operative mortality was 1.9 %, including one intraoperative death. No difference was noted in conversion rate, incidence of pancreatic fistula, morbidity, and mortality when comparing results from larger (≥30 LPD) and smaller (≤29 LPD) series. Pathology demonstrated ductal adenocarcinoma in 30.6 % of the specimens, other malignant tumors in 51.7 %, and benign tumor/disease in 17.5 %. The mean number of lymph nodes examined was 14.4 (7-32), and the rate of microscopically positive tumor margin was 4.4 %. CONCLUSIONS: In selected patients, operated on by expert laparoscopic pancreatic surgeons, LPD is feasible and safe.
Authors: William E Fisher; Sally E Hodges; Meng-Fen Wu; Susan G Hilsenbeck; F Charles Brunicardi Journal: Am J Surg Date: 2011-11-09 Impact factor: 2.565
Authors: Pier Cristoforo Giulianotti; Fabio Sbrana; Francesco Maria Bianco; Enrique Fernando Elli; Galaxy Shah; Pietro Addeo; Giuseppe Caravaglios; Andrea Coratti Journal: Surg Endosc Date: 2010-01-09 Impact factor: 4.584
Authors: Juan C Rodríguez-Sanjuán; Marcos Gómez-Ruiz; Soledad Trugeda-Carrera; Carlos Manuel-Palazuelos; Antonio López-Useros; Manuel Gómez-Fleitas Journal: World J Gastroenterol Date: 2016-02-14 Impact factor: 5.742
Authors: Thijs de Rooij; Sjors Klompmaker; Mohammad Abu Hilal; Michael L Kendrick; Olivier R Busch; Marc G Besselink Journal: Nat Rev Gastroenterol Hepatol Date: 2016-02-17 Impact factor: 46.802
Authors: Thijs de Rooij; Marc G Besselink; Awad Shamali; Giovanni Butturini; Olivier R Busch; Bjørn Edwin; Roberto Troisi; Laureano Fernández-Cruz; Ibrahim Dagher; Claudio Bassi; Mohammad Abu Hilal Journal: HPB (Oxford) Date: 2015-12-10 Impact factor: 3.647
Authors: Michael H Gerber; Daniel Delitto; Cristina J Crippen; Thomas J George; Kevin E Behrns; Jose G Trevino; Jessica L Cioffi; Steven J Hughes Journal: J Gastrointest Surg Date: 2017-05-31 Impact factor: 3.452
Authors: Igor E Khatkov; Roman E Izrailov; Arthur A Khisamov; Pavel S Tyutyunnik; Abraham Fingerhut Journal: Surg Endosc Date: 2016-07-21 Impact factor: 4.584