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2015 ; 27
(4
): 368-75
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Laparoscopic pancreaticoduodenectomy: a descriptive and comparative review
#MMPMID26361406
Merkow J
; Paniccia A
; Edil BH
Chin J Cancer Res
2015[Aug]; 27
(4
): 368-75
PMID26361406
show ga
Laparoscopic pancreaticoduodenectomy (LPD) is an extremely challenging surgery.
First described in 1994, it has been slow to gain in popularity. Recently,
however, we have seen an increase in the number of centers performing this
operation, including our own institution, as well as an increase in the quantity
of published data. The purpose of this review is to describe the current status
of LPD as described in the literature. We performed a literature search in the
PubMed database using MeSH terms "laparoscopy" and "pancreaticoduodenectomy". We
then identified articles in the English language with over 20 patients that
focused on LPD only. Review articles were excluded and only one article per
institution was used for descriptive analysis in order to avoid overlap. There
were a total of eight articles meeting review criteria, consisting of 492
patients. On descriptive analysis we found that percent of LPD due to high-grade
malignancy averaged 47% over all articles. Average operative time was 452
minutes, blood loss 369 cc's, pancreatic leak rate 15%, delayed gastric emptying
8.6%, length of hospital stay 9.4 days, and short term mortality 2.3%. Comparison
studies between open pancreaticoduodenectomy (OPD) and LPD suggested decreased
blood loss, longer operative time, similar post-operative complication rate,
decreased pain, and shorter hospital length of stay for LPD. There was also
increased number of lymph nodes harvested and similar margin free resections with
LPD in the majority of studies. LPD is a safe surgery, providing many of the
advantages typically associated with laparoscopic procedures. We expect this
operation to continue to gain in popularity as well as be offered in increasingly
more complex cases. In future studies, it will be beneficial to look further at
the oncologic outcome data of LPD including survival.