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- W2575685655 abstract "AbstractBackground Laparoscopic pancreaticoduodenectomy(LPD) is gaining momentum, but there is still uncertaintyregarding its safety, reproducibility, and oncologic appro-priateness. This review assesses the current status of LPD.Methods Our literature review was conducted in Pubmed.Articles written in English containing five or more LPDwere selected.Results Twenty-five articles matched the review criteria.Out of a total of 746 LPD, 341 were reported between 1997and 2011 and 405 (54.2 %) between 2012 and June 1,2013. Pure laparoscopy (PL) was used in 386 patients(51.7 %), robotic assistance (RA) in 234 (31.3 %), lapa-roscopic assistance (LA) in 121 (16.2 %), and hand assis-tance in 5 (0.6 %). PL was associated with shorteroperative time, reduced blood loss, and lower rate ofpancreatic fistula (vs LA and RA). LA was associated withshorter operative time (vs RA), but with higher blood lossand increased incidence of pancreatic fistula (vs PL andRA). Conversion to open surgery was required in 64 LPD(9.1 %). Operative time averaged 464.3 min (338–710)and estimated blood 320.7 mL (74–642). Cumulativemorbidity was 41.2 %, and pancreatic fistula was reportedin 22.3 % of patients (4.5–52.3 %). Mean length of hos-pital stay was 13.6 days (7–23), showing geographic var-iability (21.9 days in Europe, 13.0 days in Asia, and9.4 days in the US). Operative mortality was 1.9 %,including one intraoperative death. No difference wasnoted in conversion rate, incidence of pancreatic fistula,morbidity, and mortality when comparing results fromlarger (C30 LPD) and smaller (B29 LPD) series. Pathologydemonstrated ductal adenocarcinoma in 30.6 % of thespecimens, other malignant tumors in 51.7 %, and benigntumor/disease in 17.5 %. The mean number of lymphnodes examined was 14.4 (7–32), and the rate of micro-scopically positive tumor margin was 4.4 %.Conclusions In selected patients, operated on by expertlaparoscopic pancreatic surgeons, LPD is feasible and safe.Keywords Pancreaticoduodenectomy Laparoscopy Robot Da VinciFirst described in 1994 [1], laparoscopic pancreaticoduo-denectomy (LPD) is eventually gaining momentum atspecialized centers. Acceptance was probably slowed byboth the inherent technical limitations of laparoscopy andthe need for advanced endoscopic skills which, untilrecently, were not acquired during the training of pancreassurgeons [2]. Successful application of laparoscopy toother complex abdominal operations [3–5], availability ofnewer technologies, such as the da Vinci surgical system(Intuitive Surgical, Sunnyvale, California, USA) [6], andsurgeons’ motivation to pursue innovation and acceptchallenge [7] have all contributed to increase popularityand acceptance of LPD.Four techniques are currently employed for LPD: purelaparoscopy (PL), hand-assisted (HA) laparoscopy," @default.
- W2575685655 created "2017-01-26" @default.
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- W2575685655 date "2014-01-01" @default.
- W2575685655 modified "2023-09-27" @default.
- W2575685655 title "Laparoscopic pancreaticoduodenectomy: a systematic literature review Ugo BoggiGabriella AmoreseFabio VistoliFabio CanigliaNelide De Lio • Vittorio PerroneLinda BarbarelloMario BelluominiStefano Signori •" @default.
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