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Surgery Today

, Volume 37, Issue 7, pp 535–545 | Cite as

Laparoscopic Pancreatic Resection: The Past, Present, and Future

  • Kyoichi Takaori
  • Nobuhiko Tanigawa
Review Article

Abstract

Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreatic surgeries. Laparoscopic pancreatic resections have been performed in patients with a variety of diseases including chronic pancreatitis, pancreatic trauma, congenital hyperinsulinism, and neoplasms of the pancreas; e.g., insulinoma, mucinous cystic neoplasm, intraductal papillary mucinous neoplasm, etc. Laparoscopic pancreatic resections with an en bloc lymph node dissection have also been performed for invasive carcinomas. The long-term results after laparoscopic resections for invasive pancreatic cancer, however, are still not well defined. Laparoscopic distal pancreatectomies with or without spleen preservation may benefit patients with reduced postoperative pain, shorter hospital stay, a quicker recovery to normal activity, and better cosmetic appearances based on retrospective analyses of collective series and case reports. Prospective randomized controlled trials are needed to validate these benefits. In contrast, laparoscopic proximal pancreatectomies with or without duodenum preservation remain controversial. Although a laparoscopic pancreaticoduodenectomy and laparoscopic duodenum-preserving pancreatic head resection are technically feasible, laparoscopic reconstruction after proximal pancreatectomies is not yet generally practicable but limited to personal experiences by highly skilled endoscopic surgeons. To justify the performance of laparoscopic proximal pancreatectomies, it is mandatory to demonstrate the potential clinical benefits and safety of these complicated procedures.

Key words

Laparoscopic Whipple resection Laparoscopic duodenum-preserving pancreatic head resection Laparoscopic spleen-preserving distal pancreatectomy Intraductal papillary mucinous neoplasm Pancreatic intraepithelial neoplasia 

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Copyright information

© Springer-Verlag Tokyo 2007

Authors and Affiliations

  • Kyoichi Takaori
    • 1
  • Nobuhiko Tanigawa
    • 1
  1. 1.Department of General and Gastroenterological SurgeryOsaka Medical CollegeOsakaJapan

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