Laparoscopic pancreaticoduodenectomy: Single-surgeon experience

INTRODUCTION: Pancreaticoduodenectomy is a technically demanding surgical procedure with an incidence of postoperative complications ranging from 30% to 61%. Pancreatic surgery and associated complications pose challenges for clinicians. Adenocarcinoma of the pancreas is one of the most aggressive malignant neoplasms. Patients who undergo an R0 resection have significantly better survival than those with R1/R2 resection. This article describes the use of laparoscopic pancreaticoduodenectomy in 9 cases.
METHODS: Nine patients underwent a laparoscopic pancreaticoduodenectomy in the department of gastroenterology of a city hospital between April 2018 and August 2018. The demographic characteristics, perioperative details, and pathological results of 5 female and 4 male patients were retrospectively reviewed.
RESULTS: The mean age of the patients was 64.5±14 years. The average operative time was 593 minutes (range: 480–797minutes) and the intraoperative blood loss was 207 mL (range: 110–500 mL). None of the patients required a blood transfusion, but 1 patient required conversion to an open pancreaticoduodenectomy procedure due to uncontrolled bleeding. Prophylactic abdominal drainage was performed for all patients.

DISCUSSION AND CONCLUSION: Based on the results of this initial study, laparoscopic pancreaticoduodenectomy appears to be safe and feasible, producing satisfactory results when performed by experienced surgeons in carefully selected patients. However, long-term outcome data and a learning curve analysis should be fully demonstrated. Further studies from multiple centers are needed to support our conclusions.