Abstract
Background
Laparoscopic pancreaticoduodenectomy (LPD) has been proven feasible and safe. The artery-first approach emerged as a standard procedure in pancreatic surgery. In this manuscript, we describe both our stepwise, artery-first technique for LPD and methods for accumulating experience during the initial learning stage.
Method
This is a retrospective review of 12 patients who underwent LPD between 2012 and 2015. We classified the first five patients as the early group and the remaining seven as the late group. Here, we present our stepwise procedure for LPD, along with the perioperative results and postoperative prognoses for the two groups.
Results
The mean operative time for the 12 patients undergoing LPD was 408.3 ± 97.5 min. The average blood loss was 146.7 ± 90.2 mL. The dissection time (TD) was significantly shorter in the late group compared with the early group (140 vs. 200 min, respectively; p = 0.006). However, there was no difference in the reconstruction time (TR) between the two groups (220 vs. 200 min; p = 0.807).
Conclusion
Artery-first LPD is a feasible procedure for selected patients and has acceptable results. Using this stepwise procedure, the operative time could be reduced, mainly by reducing the time required for dissection.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the institutional research committee.
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Informed consent to the surgery and participation in the study was obtained from all of the individual participants included in the study.
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Chien-Hung Liao and Yu-Yin Liu they have contributed equally
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Liao, CH., Liu, YY., Wang, SY. et al. The feasibility of laparoscopic pancreaticoduodenectomy—a stepwise procedure and learning curve. Langenbecks Arch Surg 402, 853–861 (2017). https://doi.org/10.1007/s00423-016-1541-x
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DOI: https://doi.org/10.1007/s00423-016-1541-x