Evolution in techniques of laparoscopic pancreaticoduodenectomy: a decade long experience from a tertiary center

Palanivelu, Chinnusamy; Rajan, P. S.; Rangarajan, Muthukumaran; Vaithiswaran, V.; Senthilnathan, Palanisamy; Parthasarathi, R.; Raj, Praveen

doi:10.1007/s00534-009-0157-8

Cited by 161 publications

(102 citation statements)

References 24 publications

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“…[5] Radicality was maintained in uncinate dissection and neurolaminar tissue clearance is done lateral to superior mesenteric artery (SMA) up to the celiac axis. Inferior pancreatico-duodenal vessels are divided close to SMA.…”

Section: Technique Of Lpdmentioning

confidence: 99%

“…[3] We reported our initial experience of LPD in 42 patients in 2007 followed by large series of 75 patients in 2009. [4,5] A review of literature on LPD worldwide by Gagner et al in 2009 reported outcomes of 146 patients. The mean operating time was 439 min, average blood loss of 143 mL; median hospital stay of 18 days; and mortalities related to the procedure was 1.3 % and a complication rate of 16 %.…”

Section: Introductionmentioning

confidence: 99%

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Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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Laparoscopic pancreaticoduodenectomy (LPD) remained a formidable challenge owing to retroperitoneal location, difficult dissection near great vessels and critical intracorporeal anastomoses. Recent reviews of literature have established the feasibility and comparable short term outcomes of laparoscopic pancreaticoduodenectomy (LPD) with that of open pancreaticoduodenectomy (OPD). This study was undertaken to compare the pathological radicality of LPD with OPD. A prospective database of all patients who underwent standard pancreaticoduodenectomy from Mar 2006 to Feb 2011 was taken up for this study. 45 patients who underwent LPD and 118 patients who underwent OPD for periampullary and pancreatic head malignancy were taken up for analysis. The study groups were comparable in terms of age of presentation, ASA grades, comorbidity, type of surgery and BMI. There was no statistically significant difference with regard to tumor size, lymph node yield, node positivity rates, R1 rates and margin lengths. The pathological radicality of laparoscopic pancreaticoduodenectomy is comparable with that of open approach when performed by experienced minimal-access surgeons. Standardized protocols for evaluation of the resection margins should be mandatory in studies reporting outcomes of pancreaticoduodectomy.

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Section: Technique Of Lpdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Senthilnathan

Palanivelu

Ramanujam

et al. 2015

Indian J Surg Oncol

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show abstract

“…Although technically feasible, [77][78][79][80], at present there is no high-level evidence to suggest that laparoscopic PD is equal or superior to open surgery in terms of overall survival. In the case of a complex procedure like PD, the appreciation that the morbidity of PD (pancreatic leak, haemorrhage, delayed gastric emptying) is not related to the length of the abdominal incision, but to the extensive nature of the actual intra-abdominal surgery [81] deserves due consideration.…”

Section: Laparoscopy For Pancreatic Carcinomamentioning

confidence: 99%

Surgery for Pancreatic Carcinoma: State of the Art

Shrikhande

Barreto

2011

Indian J Surg

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Carcinoma of the pancreas remains a malignancy with a generally dismal outcome owing to the delayed presentation of the disease. To date, surgery affords the best outcomes when a complete resection can be achieved. Improvements in imaging, surgical techniques and adjuvant therapies are perceived advancements in the management of this cancer. This article reviews the latest evidence in terms of the diagnosis and management of pancreatic cancer.

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“…[5][6][7][8][9] The first results of total laparoscopic pancreatico-duodenectomy (TLPD) have revealed its feasibility and safety. [10][11][12] Major vessel involvement is supposed to be a contraindication for laparoscopic approach. Only one study has shown its feasibility in selected patients revealing lack of data.…”

Section: Introductionmentioning

confidence: 99%

Totally laparoscopic pancreaticoduodenectomy with tangential portal vein resection

Khatkov¹

2017

Laparosc Endosc Surg Sci

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Totally laparoscopic pancreaticoduodenectomy (TLP) is an oncologically safe and feasible technique. It is performed in centers experienced in laparoscopic hepatobiliary surgery. Locally advanced pancreatic cancer with portal venous invasion seems to be a relative contraindication for laparoscopic surgery. There is no definitive data supporting such an approach. Case of a 47-year-old male patient with locally advanced pancreatic cancer determined to have portal confluence invasion in the preoperative period is reported in this study. Tumor was successfully resected with laparoscopic tangential portal vein resection (TPVR). In a selected patient with locally advanced pancreatic cancer, TLP with TPVR appears to be a safe and viable procedure when performed in high-volume centers with experience in laparoscopic hepatobiliary surgery.

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Evolution in techniques of laparoscopic pancreaticoduodenectomy: a decade long experience from a tertiary center

Abstract: Laparoscopic pancreaticoduodenectomy can be safely performed by highly skilled laparoscopic surgeons. This technique can achieve adequate margins and follow oncological principles. Randomized comparative trials are needed to establish the superiority of laparoscopy versus open surgery.

Cited by 161 publications

References 24 publications

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Comparison of Pathological Radicality between Open and Laparoscopic Pancreaticoduodenectomy in a Tertiary Centre

Surgery for Pancreatic Carcinoma: State of the Art

Totally laparoscopic pancreaticoduodenectomy with tangential portal vein resection

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