Langenbeck's Archives of Surgery

, Volume 397, Issue 6, pp 1009–1012 | Cite as

Total laparoscopic partial pancreatoduodenectomy and reconstruction via laparoscopic pancreatogastrostomy

  • Tobias Keck
  • Simon Küsters
  • Ulrich Friedrich Wellner
  • Ulrich Theodor Hopt
  • Konrad Wojciech Karcz
How-I-Do-It Article

Abstract

Introduction

Minimally invasive surgery has conquered almost all niches of abdominal surgery. Even though some surgeons have shown equal lymph node ratio and oncologic radicality for laparoscopic surgery of pancreatic cancer, oncologic surgeons still take reasonably conservative views of the use of minimally invasive techniques for the treatment of pancreatic cancer, especially if located in the head of the pancreas. Laparoscopic abdominal approaches on the other hand have a potential advantage of better visualization, decreased postoperative pain, decreased use of analgetics, and shorter hospital stay. We demonstrate in this technical surgical report the first description of a total laparoscopic pancreatoduodenectomy and reconstruction via laparoscopic pancreatogastrostomy in a 74-year-old female patient with a periampullary tumor.

Discussion

After pylorus-preserving pancreatoduodenectomy by superior mesenteric artery, first approach including standard lymphadenectomy, the reconstruction involved total laparoscopic end-to-side running-suture hepaticojejunostomy, double-layer running-suture antecolic pylorojejunostomy to the first jejunal loop, and pancreatogastrostomy via posterior gastrotomy secured by two anchoring and purse-string sutures.

Keywords

Laparoscopic surgery Pancreatic surgery Pancreatoduodenectomy Pancreatogastrostomy 

Notes

Acknowledgments

We would like to thank Joachim Wellner for the artwork of this article.

Conflicts of interest

None.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Tobias Keck
    • 1
  • Simon Küsters
    • 1
  • Ulrich Friedrich Wellner
    • 1
  • Ulrich Theodor Hopt
    • 1
  • Konrad Wojciech Karcz
    • 1
  1. 1.Department of General and Visceral SurgeryUniversity of FreiburgFreiburgGermany

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