Laparoscopy-Assisted Pancreaticoduodenectomy for Pancreatic Head Tumor at a Japanese Cancer Institute

• Published in: Acta Medica Nagasakiensia Vol. 56; no. 3; pp. 93 - 97
• Main Authors: NANASHIMA, Atsushi, ABO, Takafumi, TOBINAGA, Syuuichi, NONAKA, Takashi, NAKAO, Kenjiro, HIDAKA, Shigekazu, TAKESHITA, Hiroaki, FUKUOKA, Hidetoshi, SAWAI, Terumitsu, YASUTAKE, Toru, NAGAYASU, Takeshi
• Format: Journal Article
• Language: English
• Published: Nagasaki University School of Medicine 2012
• Subjects: feasibility; intraductal papillary mucinous neoplasm; laparoscopy assisted pancreatoduodenectomy
• ISSN: 0001-6055
• DOI: 10.11343/amn.56.93

Laparoscopic surgery is a less invasive treatment option for tumors in the intraabdominal organs; however, the safety andindication of laparoscopic or laparoscopy assisted pancreaticoduodenectomy (LPD) is still controversial. We attempted LPDin four cases for intraductal papillary mucinous neoplasm (IPMN) located in the pancreatic head and we report the surgical recordsand short-term outcome. LPD was carried out in four patients including three patients with the combined type IPMN andone with the branch type, based on the International Consensus Guidelines. None of the patients had invasive carcinomabased on preoperative imaging diagnosis. Laparoscopic procedures were performed until isolation of the pancreas head andduodenum, and final resection of PD and intestinal reconstruction were performed using small incision laparotomy (7-8cm).The mean total operating time was 882 minutes (820-932 minutes), mean blood loss was 925ml (610-1550ml) and red celltransfusion was not required in any patients. One patient underwent reoperation for bleeding at the pancreaticojejunostomysite at day 1. Mean duration until patients were able to walk was 3.5 days (2-6 days) and duration of use of analgesia was limitedto within 7 days. Grade B pancreatic fistula was observed in one patient and jejunal ileus was observed in one patient.There were no deaths. LPD was safely performed and blood loss was limited, although the operating time was long.Postoperative recovery in patients without complications might be better than the conventional PD under laparotomy. Futurestudy is necessary.