A Single-Institution Prospective Study of Laparoscopic Pancreatic Resection

Cunha, Antonio Sa; Rault, A.; Beau, Cédric; Laurent, C.; Collet, Denis; Masson, Bernard

doi:10.1001/archsurg.143.3.289

Cited by 75 publications

(57 citation statements)

References 43 publications

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“…Studies suggest the minimally invasive approach is not only feasible but equivalently efficacious and safe: with similar perioperative morbidity and mortality (6)(7)(8)(9)(10)(15)(16)(17)(18)(19). In particular, the minimally invasive approach to distal pancreatectomy has been widely accepted and clearly demonstrated advantages such as reduced blood loss, reduced overall complication rate, reduced surgical site infection and shorter hospital length of stay (7)(8)(9)(10)17).…”

Section: Discussionmentioning

confidence: 99%

“…In particular, the minimally invasive approach to distal pancreatectomy has been widely accepted and clearly demonstrated advantages such as reduced blood loss, reduced overall complication rate, reduced surgical site infection and shorter hospital length of stay (7)(8)(9)(10)17). Laparoscopic TP remains a rare procedure, but has shown recent increased use in high volume centers and similarly shown to be safe and feasible (15,16,18,19). A comprehensive review of our initial experience revealed those receiving LTPIAT had significantly shorter hospitalization with median length of stay being 10.5 compared to 14 days for open surgery as well as significant decrease in median postoperative dose of opiate on discharge in the laparoscopic group compared to open (16).…”

Section: Discussionmentioning

confidence: 99%

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Laparoscopic total pancreatectomy with islet autotransplantation for chronic pancreatitis

et al. 2016

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Background: Pain from chronic pancreatitis can be debilitating and have far-reaching personal and societal consequences. These consequences can include patient debilitation, worsening of comorbid conditions, narcotic dependence, and implications for health care policy. A variety of surgical procedures have shown limited efficacy for relieving pain in this cohort of patients, and a highly select subset may benefit from a total pancreatectomy (TP). While a brittle form of diabetes can result from TP alone, when combined with islet cell autotransplantation this procedural complication can be minimized. Further, utilizing a minimally invasive approach may be associated with decreased periprocedural pain and length of hospital stay.Methods: We describe our experience at a single high-volume center in the United States. We present our preferred preoperative evaluation, our updated operative techniques, and the standard perioperative care required following this complex laparoscopic procedure.Results: Between 2013 and 2015, there were 20 patients who underwent laparoscopic total pancreatectomy with islet autotransplantation (LTPIAT). Perioperative mortality was 0%.Conclusions: At a high volume pancreatic center with experienced laparoscopic pancreatic surgeons, LTPIAT is feasible and safe for the management of chronic pancreatitis refractory to prior medical and surgical therapies.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Laparoscopic total pancreatectomy with islet autotransplantation for chronic pancreatitis

et al. 2016

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“…[10][11][12] Recently, there have been increasing reports of successful laparoscopic pancreatectomies, however, laparoscopic total pancreatectomies have rarely been described in the literature. 3,13,14 Casadei et al 14 reported a laparoscopically-assisted total pancreatectomy which consisted of a totally laparoscopic body-tail mobilization followed by the opening of a right subcostal mini-laparotomy in order to perform a pancreaticoduodenectomy and a reconstructive phase. In this study, we performed a total pancreatectomy for a patient with a main duct IPMN of the pancreas because the 8 tumor involved the entire main pancreatic duct, and the possibility of malignant transformation was considered to be high based on the preoperative diagnostic images.…”

Section: Discussionmentioning

confidence: 99%

Hand-assisted laparoscopic total pancreatectomy for a main duct intraductal papillary mucinous neoplasm of the pancreas

et al. 2011

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The laparoscopic approach to pancreatectomy entails a number of restrictions in performing major pancreatic surgery. This report describes a hand-assisted laparoscopic total pancreatectomy performed for a main duct IPMN of the pancreas.Dissection of the gastroduodenal artery and splenic artery, and the transection of the duodenum were done through the midline mini-laparotomy, while mobilization of the spleen and the pancreatic tail and body, and Kocher's maneuver were performed in the hand-assisted laparoscopic approach. Furthermore, dissection of lymph nodes in the hepatoduodenal ligament, removal of the gallbladder, division of the hepatic duct, tunneling of the pancreas, and dissection of the pancreas from the SMV and SMA were possible to perform safely under a pure laparoscopic technique with an excellent laparoscopic view. The reconstruction procedures were performed through the mini-laparotomy. The hand-assisted laparoscopic total pancreatectomy should be a considered for the treatment of selected patients because it has various advantages as one type of minimally invasive surgery.3

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“…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.…”

Section: Introductionmentioning

confidence: 99%

The Current State of Minimally Invasive Distal Pancreatectomy

Lee

Vollmer

2013

Curr Surg Rep

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Since its advent nearly 15 years ago, minimally invasive distal pancreatectomy has gradually increased in popularity. Numerous reports have now documented the safety and feasibility of the laparoscopic approach to left-sided pancreas resections, and large-scale comparisons have been made between the laparoscopic and open approaches regarding perioperative outcomes for both benign and malignant lesions. Furthermore, several highvolume centers have described their initial experiences with robotic distal pancreatectomy in comparison with laparoscopic and open resections. This review summarizes the literature for both laparoscopic and robotic distal pancreatectomy over the past year, highlighting novel advances. Although studies suggest that minimally invasive distal pancreatectomy is equivalent if not superior to the open approach in some respects, randomized studies are needed to best delineate the putative benefits.

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A Single-Institution Prospective Study of Laparoscopic Pancreatic Resection

Abstract: Hypothesis: Laparoscopic pancreatic resection can safely duplicate all of the open pancreatic procedures. Design: A prospective evaluation of laparoscopic pancreatic resection. Surgical procedure, postoperative course, and follow-up data were collected.

Cited by 75 publications

References 43 publications

Laparoscopic total pancreatectomy with islet autotransplantation for chronic pancreatitis

Laparoscopic total pancreatectomy with islet autotransplantation for chronic pancreatitis

Hand-assisted laparoscopic total pancreatectomy for a main duct intraductal papillary mucinous neoplasm of the pancreas

The Current State of Minimally Invasive Distal Pancreatectomy

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