Laparoscopic pancreatic resection—a review

Justin, Viktor; Fingerhut, Abe; Khatkov, Igor; Uranues, Selman

doi:10.21037/tgh.2016.04.02

Cited by 15 publications

(10 citation statements)

References 79 publications

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“…The indications for LDP are similar to those for open distal pancreatectomy (10,(24)(25)(26): distal pancreatectomy for benign, borderline, or malignant tumors of the pancreatic body and tail, distal pancreatectomy for pancreatic injury and chronic or acute pancreatitis with pseudocyst located in the pancreatic body and tail. Obvious contraindications for LDP include: invasion of surrounding organs or critical vasculature, distant metastasis in cancer (22), or acute pancreatitis (27). Obesity is not a formal contra-indication although it makes the operation more challenging (15,24).…”

Section: Indications For Laparoscopic Distal Pancreatectomymentioning

confidence: 99%

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Laparoscopic distal pancreatectomy: better than open?

Fingerhut¹,

Uranues²,

Khatkov³

et al. 2018

Transl. Gastroenterol. Hepatol.

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Distal pancreatectomy is well suited to the laparoscopic approach. Laparoscopic distal pancreatectomy (LDP) provides the same postoperative recovery advantages reputed to minimal access surgery. However, there have been fears as to the safety of LDP in terms of life-threatening intra-operative events and post-operative complications, adequate carcinological outcomes as compared to traditional (open) distal pancreatectomy (ODP) when performed for cancer, as well as to whether the laparoscopic approach is well adapted to the variety of diseases that may affect the pancreas (ranging from trauma to benign or malignant disease) and whether the minimal access approach is well adapted to perform pancreatic surgery safely in the obese, the elderly or the frail. In this review of the literature, we sought to determine whether LDP was as safe, provided the same oncological outcomes and was applicable to all diseases involving the body and tail of the pancreas, and to particular patient characteristics, compared to the traditional open approach. Last we looked at cost issues. We concluded that this review of the literature allowed to state that laparoscopic distal pancreatectomy is feasible and safe for a wide range of diseases, both benign and malignant. Morbidity, mortality, and probably, also, carcinological outcomes are comparable to open surgery. The overall costs are similar but the advantages of minimal access surgery make it the preferred approach, once the surgical expertise is acquired and present.

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Section: Indications For Laparoscopic Distal Pancreatectomymentioning

confidence: 99%

“…Morbidity is essentially related to post-operative pancreatic fistula (POPF), wound infection and omental infarction (27). This might explain why there is a wide range of morbidity rates because authors have used many different definitions for POPF in their literature.…”

Section: Post-operative Pancreatic Fistula (Popf)mentioning

confidence: 99%

Laparoscopic distal pancreatectomy: better than open?

Fingerhut¹,

Uranues²,

Khatkov³

et al. 2018

Transl. Gastroenterol. Hepatol.

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“…Frey's procedure for chronic pancreatitis, involving a combination of pancreatic head resection with drainage of the remnant pancreases, is reserved for patients with debilitating pain, with the laparoscopic equivalent gaining popularity in recent years due to its noninvasiveness and cosmetic benefit [1][2][3][4][5][6]. Tan et al described the successful treatment of 7 out of 9 patients who underwent laparoscopic Frey's procedure for chronic pancreatitis, showing the comparable outcome of laparoscopic Frey's procedure to that of open surgery [8].…”

Section: Discussionmentioning

confidence: 99%

“…Frey's procedure for chronic pancreatitis, involving longitudinal pancreaticojejunostomy and coring out of the pancreatic head, is reserved for patients with debilitating pain [1][2][3]. Recently, laparoscopic pancreatic surgery has become increasingly preferred because of its noninvasiveness [4][5][6]. However, limited reports of Frey's procedure performed laparoscopically exist [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic Frey’s Procedure for Chronic Pancreatitis in a Japanese Patient

et al. 2020

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Unusual clinical course Background: Chronic pancreatitis is a slowly progressive inflammatory disease, affecting patients' quality of life due to chronic pain as well as endocrine and exocrine pancreatic insufficiency. Patients often choose surgery if medical and endoscopic interventions fail. Surgical approaches for chronic pancreatitis can be categorized as follows: resection of the diseased gland, diversion and drainage of the dilated pancreatic duct, or a combination of these approaches. Frey's procedure, which involves resection and drainage by longitudinal pancreaticojejunostomy and coring out of the pancreatic head, is reserved for patients with debilitating pain. Although laparoscopic surgery is gaining popularity in recent years due to its noninvasiveness and cosmetic benefit, few reports describe performing Frey's procedure laparoscopically. Case Report: A 36-year-old Japanese female with chronic pancreatitis complained of back pain and pain in the left upper quadrant abdomen. Plain computed tomography of her abdomen revealed a dilated main pancreatic duct containing diffuse calculi extending to the pancreatic parenchyma. Laboratory findings, including amylase level, were within normal ranges. She was diagnosed with chronic pancreatitis, and subsequently underwent a laparoscopic Frey's procedure. To our knowledge, we are the first to improve operative field visibility by using a Penrose drain to move the stomach from the line of sight. Postoperatively, the patient did well and was discharged 10 days after surgery. She remained symptom-free without medications for 80 months. Conclusions: Due to its noninvasive nature and cosmetic advantages, laparoscopic Frey's procedure may be an attractive therapeutic option for chronic pancreatitis.

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“…The use of the proposed pancreatic stump closure techniques after distal pancreatectomy led to a decrease of the frequency and severity of postoperative complications, a decrease of the frequency and severity of postoperative pancreatic fistulas, and a decrease of the postoperative hospital-stay. Keywords: pancreas, distal pancreatectomy, corporocaudal pancreatectomy, pancreatic tumors, postoperative pancreatic fistula В в е д е н и е. Дистальная резекция поджелудочной железы (ДРПЖ) составляет около трети всех резекций поджелудочной железы [1,2]. Показаниями к выполнению ДРПЖ являются ограниченное поражение паренхимы при деструктивном панкреатите, хронический панкреатит, эндокринные опухоли, внутрипротоковые муцинозные новообразования, псевдокисты поджелудочной железы (ПЖ), кистозные новообразования, метастазы рака других органов, травмы ПЖ с поражением протоков [3][4][5], а также комбинированные вмешательства при местно-распространенных опухолях смежных органов (желудка, толстой кишки) на тело и хвост ПЖ.…”

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The Dependence of Direct Results of Distal Pancreatectomies on Different Pancreatic Stump Closure Techniques

Восканян¹,

Найденов²,

Uteshev³

et al. 2018

VESTNIK KHIRURGII IMENI I.I.GREKOVA

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The OBJECTIVE is to study the effect of application of different pancreatic stump closure techniques to the postoperative period, the frequency and severity of postoperative complications including postoperative pancreatic fistulas after distal pancreatectomies. MATERIAL AND METHODS. The clinical material consisted of 126 patients who underwent distal pancreatectomies (isolated or in combination with surgical interventions on the adjacent organs of the abdominal cavity and retroperitoneal space). The patients were divided into 4 groups depending on the pancreatic stump closure techniques (isolated suturing of the main pancreatic duct of the pancreatic stump with its omentization by gastrocolic omentum or local sealing its by hemostatic sponge (control group); using a local biological glue 2-octylcyanoacrylate; using the Endoscopic Linear Cutter Echelon; external transduodenal transnasal drainage of the enlarged main pancreatic duct of the pancreatic stump). We evaluated the influence of different pancreatic stump closure techniques after distal pancreatectomies on the postoperative period as well the frequency and severity of postoperative pancreatic fistulas depending on the diameter of the main pancreatic duct of pancreatic stump. RESULTS. The overall rate of postoperative complications in the control group of patients was 45.8 %, and was due to an increase in the frequency of specific complications (35.4 %). The most frequent complication in the control group of patients was postoperative pancreatic fistulas – 29.2 %. The statistically significant decrease of frequency and severity of postoperative complications, frequency and severity of postoperative pancreatic fistulas and decrease of postoperative hospital-stay after the application of the proposed different pancreatic stump closure techniques were revealed in comparison with the control group of patients. There was no hospital mortality. CONCLUSION. Distal pancreatectomy with «standard» pancreatic stump closure techniques accompanied by high frequency and severity of postoperative complications, as well as postoperative pancreatic fistulas. The use of the proposed pancreatic stump closure techniques after distal pancreatectomy led to a decrease of the frequency and severity of postoperative complications, a decrease of the frequency and severity of postoperative pancreatic fistulas, and a decrease of the postoperative hospital-stay.

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Laparoscopic pancreatic resection—a review

Cited by 15 publications

References 79 publications

Laparoscopic distal pancreatectomy: better than open?

Laparoscopic distal pancreatectomy: better than open?

Laparoscopic Frey’s Procedure for Chronic Pancreatitis in a Japanese Patient

The Dependence of Direct Results of Distal Pancreatectomies on Different Pancreatic Stump Closure Techniques

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