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- W4230557802 abstract "Background: The reconstruction phase (hepaticojejunostomy, pancreaticojejunostomy, and gastrojejunostomy/duodenojejunostomy) during laparoscopic pancreaticoduodenectomy is technically challenging. The purpose of this video is to demonstrate 8 simple steps that are independent of laparoscopic technical ability, which can help facilitate the reconstruction phase during laparoscopic pancreaticoduodenectomy. Methods: We used videos from laparoscopic pancreaticoduodenectomies performed at our institutions to demonstrate tips we have learned that can hopefully assist other pancreatic surgeons to decrease the steepness of their learning curve for this part of the operation. The video shows reconstructions with and without using these tips to demonstrate the benefits. We use a standard 6 port placement with patients in the supine, split leg position. Results: There are 8 simple tips that any surgeon can perform to help make reconstruction during laparoscopic pancreaticoduodenectomy easier. They are: 1) Cut the back row of the bile duct 2-3mm longer than the front row during the resection phase; 2) Perform the hepaticojejunostomy anastomosis with the surgeon standing on the right side of the patients; 3) Leave a clamp on the bile duct when performing the hepaticojejunostomy anastomosis; 4) Dissect out the pancreatic duct and cut it 2-3mm longer than the pancreatic parenchyma when dividing the pancreatic neck during the resection phase of the operation; 5) Use pancreatic duct stents prior to stitch placement to facilitate construction of the inner layer of the duct-to-mucosa pancreaticojejunostomy; 6) Use stay sutures to facilitate stitch placement on the inner layer of the duct-to-mucosa pancreaticojejunostomy; 7) Split the greater omentum vertically to facilitate creation of the duodenojeunostomy or gastrojejunostomy; 8) Control the location of the duodenojeunostomy or gastrojejunostomy with a stay suture. Conclusion: Laparoscopic reconstruction during laparoscopic pancreaticoduodenctomy is technically challenging. The 8 simple steps described can greatly assist surgeons while learning to perform this complex operation." @default.
- W4230557802 created "2022-05-11" @default.
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- W4230557802 date "2019-03-01" @default.
- W4230557802 modified "2023-10-16" @default.
- W4230557802 title "8 tips to make the reconstruction phase during laparoscopic pancreaticoduodenectomy easier" @default.
- W4230557802 doi "https://doi.org/10.1016/j.hpb.2019.03.155" @default.
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