A totally laparoscopic pylorus-preserving pancreaticoduodenectomy and reconstruction

Although many reports have described laparoscopic pancreatic surgery, laparoscopic pancreaticoduodenectomy (PD) has not been widely employed because of technical difficulties. This paper describes a totally laparoscopic pylorus-preserving PD performed for an intraductal papillary-mucinous neoplasm....

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2009-04, Vol.39 (4), p.359-362
Main Authors: Cho, Akihiro, Yamamoto, Hiroshi, Nagata, Matsuo, Takiguchi, Nobuhiro, Shimada, Hideaki, Kainuma, Osamu, Souda, Hiroaki, Gunji, Hisashi, Miyazaki, Akinari, Ikeda, Atsushi, Tohma, Tomoko
Format: Article
Language:English
Subjects:
Aged
Female
Humans
Laparoscopy - methods
Magnetic Resonance Imaging
Pancreatic Cyst - diagnosis
Pancreatic Cyst - surgery
Pancreatic Neoplasms - diagnosis
Pancreatic Neoplasms - surgery
Pancreaticoduodenectomy - methods
Reconstructive Surgical Procedures - methods
Tomography, X-Ray Computed
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Summary:Although many reports have described laparoscopic pancreatic surgery, laparoscopic pancreaticoduodenectomy (PD) has not been widely employed because of technical difficulties. This paper describes a totally laparoscopic pylorus-preserving PD performed for an intraductal papillary-mucinous neoplasm. After the laparoscopic resection, an end-to-side pancreaticojejunostomy including duct-to-mucosa anastomosis without a stenting tube, an approximation of the pancreas stump and jejunal wall, an end-to-side hepaticojejunostomy, and an end-to-side duodenojejunostomy were performed intracorporeally. The patient recovered without any complications and was discharged on the 14th postoperative day. The surgical margin was free of neoplastic changes. Although the experience is limited and the appropriate indications must await future studies, this case indicates that a laparoscopic pylorus-preserving PD can be feasible, safe, and effective in highly selected patients.
ISSN:1436-2813
DOI:10.1007/s00595-008-3853-0