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Laparoscopic pancreatoduodenectomy

Yu-Hua Zhang, Cheng-Wu Zhang, Zhi-Ming Hu, De-Fei Hong
Pancreatic duct adenocarcinoma is one of the most fatal malignancies, with R0 resection remaining the most important part of treatment of this malignancy. However, pancreatectomy is believed to be one of the most challenging procedures and R0 resection remains the only chance for patients with pancreatic cancer to have a good prognosis. Some surgeons have tried minimally invasive pancreatic surgery, but the short- and long-term outcomes of pancreatic malignancy remain controversial between open and minimally invasive procedures...
August 28, 2016: World Journal of Gastroenterology: WJG
Mushegh A Sahakyan, Bård Ingvald Røsok, Airazat M Kazaryan, Leonid Barkhatov, Sven-Petter Haugvik, Åsmund Avdem Fretland, Dejan Ignjatovic, Knut Jørgen Labori, Bjørn Edwin
BACKGROUND: Previous studies report successful application of laparoscopic pancreatic enucleation (LPE). However, the evidence is limited to small series. This study aimed to evaluate the indications, technique and outcome of LPE at a tertiary care institution. METHODS: Between February 1998 and April 2016, 45 consecutive LPEs were performed at Oslo University Hospital-Rikshospitalet. Twenty-four (53.3 %) patients subjected to right-sided LPE (RLPE) were compared with 21 (46...
September 12, 2016: Surgical Endoscopy
Niccolò Napoli, Emanuele F Kauffmann, Francesca Menonna, Vittorio Grazio Perrone, Stefania Brozzetti, Ugo Boggi
Robotic assistance improves surgical dexterity in minimally invasive operations, especially when fine dissection and multiple sutures are required. As such, robotic assistance could be rewarding in the setting of robotic pancreatoduodenectomy (RPD). RPD was implemented at a high volume center with preemptive experience in advanced laparoscopy. Indications, surgical technique, and results of RPD are discussed against the background of current literature. RPD was performed in 112 consecutive patients. Conversion to open surgery was required in three patients, despite nine required segmental resection and reconstruction of the superior mesenteric/portal vein...
September 10, 2016: Updates in Surgery
Igor E Khatkov, Roman E Izrailov, Arthur A Khisamov, Pavel S Tyutyunnik, Abraham Fingerhut
BACKGROUND: Laparoscopic pancreatoduodenectomy (LPD) with concomitant resection of major portal vessels has recently emerged as feasible and safe, with similar morbidity and mortality as well as oncologic outcome compared with patients undergoing open PD with major vascular resection. MATERIALS AND METHODS: Of a consecutive series of 133 LPD, eight patients underwent concomitant superior mesenteric vein/portal vein (SMV/PV) resection and reconstruction with the intent of achieving a R0 resection...
July 21, 2016: Surgical Endoscopy
Yosuke Inoue, Akio Saiura, Takafumi Sato, Takeaki Ishizawa, Junichi Arita, Yu Takahashi, Naoki Hiki, Takeshi Sano, Toshiharu Yamaguchi
PURPOSE: Pancreatoduodenectomy (PD) is the standard yet complicated procedure for periampullary tumors. To introduce a laparoscopic approach for PD (Lap-PD), a robust and objective assessment system to evaluate the quality of this approach is needed. We describe a phase 1 surgical trial of Lap-PD (Registration ID: UMIN000015328) as a triad of surgery, novel self-assessment system, and feedback discussion implementing the Idea, Development, Exploration, Assessment, Long-term study (IDEAL) guidelines...
June 21, 2016: Langenbeck's Archives of Surgery
Marcel Autran C Machado, Rodrigo C Surjan, Tiago Basseres, Izabella B Silva, Fábio F Makdissi
BACKGROUND: Laparoscopic pancreatic surgery has gradually expanded to include pancreatoduodenectomy (PD). This study presents data regarding the efficacy of laparoscopic PD in a single center. METHODS: This was a single-cohort, prospective observational study. From March 2012 to September 2015, 50 consecutive patients underwent laparoscopic PD using a five-trocar technique. Reconstruction of the digestive tract was performed with double jejunal loop technique whenever feasible...
August 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Hongyu Li, Bing Peng
Total laparoscopic pylorus-preserving pancreatoduodenectomy (tLPPPD) has been demonstrated to be a safe and feasible surgery for pancreatic malignant diseases located in the head or uncinate process, with the advantages including minimal invasion, lower blood loss and a shorter hospital stay, compared with traditional open pancreatoduodenonectomy. Elderly patients theoretically have a lower capability to tolerate complex surgeries. The impairment of heart and pulmonary reserve function often leads to a high risk of post-operative cardiopulmonary complications...
April 2016: Oncology Letters
M A Machado, R C Surjan, T Bassères, F F Makdissi
No abstract text is available yet for this article.
June 2016: Journal of Visceral Surgery
Nobutsugu Abe, Yoshikazu Hashimoto, Shouhei Kawaguchi, Hayato Shimoyama, Youhei Kojima, Eri Yoshimoto, Eri Kondo, Atsuko Ohki, Hirohisa Takeuchi, Gen Nagao, Yutaka Suzuki, Tadahiko Masaki, Toshiyuki Mori, Masanori Sugiyama
A 54-year-old man had a 65-mm infrapapillary, circular, and laterally spreading tubular adenoma in the distal second and proximal third parts of the duodenum. The papilla was 15 mm from the proximal margin of the tumor. Because the patient requested organ-preserving laparoscopic surgery, we conducted laparoscopy-assisted pancreas-sparing duodenectomy (LAPSD). LAPSD consists of five major procedures: (i) laparoscopic wide Kocher maneuver and transection of the proximal jejunum; (ii) laparoscopic separation of the duodenum from the pancreas; (iii) creation of a small upper median laparotomy; (iv) extracorporeal completion of the segmental duodenectomy; and (v) extracorporeal intestinal reconstruction...
February 2016: Asian Journal of Endoscopic Surgery
Juan Santiago Azagra, Luca Arru, Sergio Estévez, Makkai-Popa Silviu-Tiberiu, Virginie Poulain, Martine Goergen
INTRODUCTION: The "artery-first approach" (AFA) to the superior mesenteric artery allows an early assessment of resectability of pancreatic tumours and could improve the benefits of laparoscopy, reducing invasiveness, especially for unresectable tumours. AIM: To describe our technique of pure laparoscopic pancreatoduodenectomy (PLPD) with the AFA, and to report the surgical outcomes of this procedure in a small series of 12 patients through a retrospective analysis of a prospectively collected database...
September 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Shailesh V Shrikhande, Masillamany Sivasanker
Minimally invasive pancreatoduodenectomy is currently a feasible option in selected patients at high volume centers with available expertise. Although the procedure has been described two decades ago, laparoscopic surgeons have been reluctant to perform it since it is technically demanding. Currently there is no standardized training process for minimally invasive pancreatoduodenectomy and this is required to ensure the safety of the procedure. Even the open pancreatoduodenectomy can be a challenging procedure where the outcome depends much upon the patient volume and surgeon's experience...
August 27, 2015: World Journal of Gastrointestinal Surgery
Christopher R Shubert, Amy E Wagie, Michael B Farnell, David M Nagorney, Florencia G Que, K Marie Reid Lombardo, Mark J Truty, Rory L Smoot, Michael L Kendrick
BACKGROUND: A clinical risk score for pancreatic fistula (CRS-PF) was recently reported to predict postoperative pancreatic fistula (POPF) after pancreatoduodenectomy (PD). An independent external validation has not been performed. Our hypothesis was that CRS-PF predicts POPF after both laparoscopic and open PD. STUDY DESIGN: The CRS-PF was calculated from a retrospective review of patients undergoing PD from January 2007 to February 2014. Postoperative pancreatic fistula was graded using International Study Group of Pancreatic Fistula criteria...
September 2015: Journal of the American College of Surgeons
May C Tee, Kristopher P Croome, Christopher R Shubert, Michael B Farnell, Mark J Truty, Florencia G Que, K Marie Reid-Lombardo, Rory L Smoot, David M Nagorney, Michael L Kendrick
BACKGROUND: Elderly patients undergoing open pancreatoduodenectomy (OPD) are at increased risk for surgical morbidity and mortality. Whether totally laparoscopic pancreatoduodenectomy (TLPD) mitigates these risks has not been evaluated. METHODS: A retrospective review of outcomes in patients submitted to pancreatoduodenectomy during 2007-2014 was conducted (n = 860). Outcomes in elderly patients (aged ≥70 years) were compared with those in non-elderly patients with respect to risk-adjusted postoperative morbidity and mortality...
October 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Isacco Damoli, Giovanni Butturini, Marco Ramera, Salvatore Paiella, Giovanni Marchegiani, Claudio Bassi
During the past 20 years the application of a minimally invasive approach to pancreatic surgery has progressively increased. Distal pancreatectomy is the most frequently performed procedure, because of the absence of a reconstructive phase. However, middle pancreatectomy and pancreatoduodenectomy have been demonstrated to be safe and feasible as well. Laparoscopic distal pancreatectomy is recognized as the gold standard treatment for small tumors of the pancreatic body-tail, with several advantages over the traditional open approach in terms of patient recovery...
July 2015: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Giuseppe Zimmitti, Alberto Manzoni, Pietro Addeo, Marco Garatti, Alberto Zaniboni, Philippe Bachellier, Edoardo Rosso
BACKGROUND: Laparoscopic pancreatoduodenectomy (LPD) is a complex procedure. Critical steps are achieving a negative retroperitoneal margin and re-establishing pancreatoenteric continuity minimizing postoperative pancreatic leak risk. Aiming at increasing the rate of R0 resection during pancreatoduodenectomy, many experienced teams have recommended the superior mesenteric artery (SMA)-first approach, consisting in early identification of the SMA at its origin, with further resection guided by SMA anatomic course...
April 2016: Surgical Endoscopy
Defei Hong, Yingbin Liu, Shuyou Peng, Xiaodong Sun, Zhifei Wang, Jian Cheng, Guoliang Shen, Yuanbiao Zhang, Dongsheng Huang
BACKGROUND: Even though more and more cases of laparoscopic central pancreatectomy (LCP) are reported (Machado et al. in Surg Laparosc Endosc Percutan Tech 23(6):486-490, 2013; Hong et al. in World J Surg Oncol 10:223, 2012; Gonzalez et al. in JOP 14(3):273-276, 2013, Zhang et al. in J Laparoendosc Adv Surg Tech A 23(11):912-918, 2013; Sucandy et al. in N Am J Med Sci 2(9):438-441, 2010; Sa Cunha et al. in Surgery 142(3):405-409, 2007), the management for pancreatic stumps remains the most technically challenging part which is the same as in pancreatoduodenectomy (PD), making it the bottleneck for laparoscopic pancreatic surgery...
February 2016: Surgical Endoscopy
Stefano Berti, Alessia Ferrarese, Cosimo Feleppa, Elisa Francone, Valter Martino, Claudio Bianchi, Emilio Falco
BACKGROUND: In patients affected by distal biliary obstruction deemed unsuitable for pancreatoduodenectomy, biliary diversion is the only proposable option. Defined goals of this treatment are: relief from jaundice preventing its related complications, reduction of in-hospital stay and adequate control of pain. Palliation can be obtained either by surgical or conservative procedures (endoscopic stenting or percutaneous treatment). Considering early complications' incidence, surgical approach has always been reserved for low surgical risk patients with longer survival perspectives, while recently developed long-lasting patency stents enlarged mini-invasive application resort...
September 2015: International Journal of Surgery
Andrzej Budzyński, Anna Zub-Pokrowiecka, Anna Zychowicz, Michał Pędziwiatr, Mateusz Wierdak, Maciej Matłok, Małgorzata Zając
We present a case of a 55-year-old female patient with pancreatic head cancer who was treated with total laparoscopic pylorus-preserving pancreatoduodenectomy (TLPD) on 13.12.2013. The procedure as well as the postoperative course was uncomplicated. The patient was mobilized on the day of surgery; a liquid diet was introduced on day 1 and a full hospital diet on day 2 postoperatively. Drains were removed on the 3(rd) day after the procedure. Length of hospital stay was 6 days. The final pathology report confirmed the diagnosis of cancer...
September 2014: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
Aníval Ernesto Ramos Socarrás, Moraima Emilia Vallés Gamboa, José Rolando Rodríguez Núñez, Carlos Manuel Neyra Rodríguez, Francisco Antonio Vargas La O
Gastrointestinal stromal tumor (GIST) represents less than 3% of gastrointestinal malignancies. However, it is the most common mesenchymal tumor of the digestive tract. GIST is characterized by the expression tyrosine kinase CD117, which differentiates it from other mesenchymal tumors such as leiomyomas, leio-miosarcomas, leiomyoblastoma and neurogenic tumors that do not express this protein. 70-80% of the GIST are benign and located mostly in the stomach and small intestine (> 90%).They can also arise from any portion of the digestive tract, mesentery, omentum and retroperitoneum...
July 2014: Revista de Gastroenterología del Perú: órgano Oficial de la Sociedad de Gastroenterología del Perú
Ulrich Friedrich Wellner, Simon Küsters, Olivia Sick, Caroline Busch, Dirk Bausch, Peter Bronsert, Ulrich Theodor Hopt, Konrad Wojciech Karcz, Tobias Keck
PURPOSE: We compared the outcome of hybrid laparoscopic pylorus-preserving pancreatoduodenectomy (lapPPPD) and open PPPD (oPPPD) in a retrospective case-matched study. METHODS: Patients operated from 2010 to 2013 by lapPPPD were matched 1:1 for age, sex, histopathology, American Society of Anesthesiologists category and body mass index to oPPPD patients operated from 1996 to 2013. RESULTS: Patients eligible for lapPPPD are a risk group due to a high rate of soft pancreata...
October 2014: Langenbeck's Archives of Surgery
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