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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2011

01-05-2011 | Pancreatic Tumors

Laparoscopic Pancreatoduodenectomy: A Review of 285 Published Cases

Authors: Andrew A. Gumbs, MD, Angel M. Rodriguez Rivera, MD, Luca Milone, MD, PhD, John P. Hoffman, MD

Published in: Annals of Surgical Oncology | Issue 5/2011

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Abstract

Background

Given the difficulty level of minimally invasive pancreatoduodenectomy (MIPD), limited data exist for a comparison to open pancreatoduodenectomies. As the technique becomes more diffuse, issues regarding the adequacy of oncologic margins and lymph node retrieval need to be addressed.

Methods

All published cases of MIPD were examined. Variables analyzed included conversion rates, operating room time, estimated blood loss, length of stay, follow-up, complications, mortality, lymph node retrieval, and margins.

Results

Twenty-seven articles describing outcomes after MIPD were found, and a total of 285 cases were described. Main malignancy treated was pancreatic adenocarcinoma, accounting for 32% of all cases. Eighty-seven percent were performed totally laparoscopically, and 13% were performed with a hand-assisted approach to facilitate the reconstruction step of the procedure. The rate of conversion to an open procedure was 9%. Estimated blood loss had a weighted average (WA) of 189 mL. Average length of stay had a WA of 12 days, and average follow-up had a WA of 14 months. The overall complication rate was 48%, and the overall mortality rate was 2%. Average lymph nodes retrieved ranged from 7 to 36 nodes, with a WA of 15 nodes, and positive margins of resection were reported to be positive in 0.4% of patients with malignant disease.

Conclusions

This review found similar outcomes with respect to perioperative morbidity and mortality rates compared to open pancreatoduodenectomies. The oncologic goals of pancreatic resection may be able to be achieved by MIPD, but longer follow-up and larger series are still needed.
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Metadata
Title
Laparoscopic Pancreatoduodenectomy: A Review of 285 Published Cases
Authors
Andrew A. Gumbs, MD
Angel M. Rodriguez Rivera, MD
Luca Milone, MD, PhD
John P. Hoffman, MD
Publication date
01-05-2011
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 5/2011
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-010-1503-4

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