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Total Laparoscopic Pancreatoduodenectomy

  • Maurice J. W. Zwart
  • Thijs de Rooij
  • Olivier R. C. Busch
  • Michael F. Gerhards
  • Sebastiaan Festen
  • Marc G. H. BesselinkEmail author
Chapter

Abstract

Pancreatoduodenectomy is the treatment of choice for pancreatic head and periampullary cancers and high-risk pancreatic cysts. Laparoscopic pancreatoduodenectomy, firstly performed in 1994 [1], has gained popularity only slowly, probably because of the required extensive laparoscopic dissection and the difficulty of the pancreatic and bile duct anastomoses. Improvements in surgical expertise, instrumentation and several cohort studies have apparently driven to the recent increased interest in laparoscopic pancreatoduodenectomy [2]. Nevertheless, only a few centers have acquired adequate experience with this complex procedure. A recent pan-European survey demonstrated that although 73% of pancreatic surgeons performed minimally invasive distal pancreatectomy, only 4.4% of surgeons had performed more than ten minimally invasive pancreatoduodenectomies [3]. A laparoscopic approach to pancreatic and periampullary lesions may enhance postoperative functional recovery and potentially shorten time to start with adjuvant chemotherapy. Naturally, a learning curve arises with the adaptation of a laparoscopic approach. This is reflected in reports on the laparoscopic pancreatoduodenectomy learning curve which is completed faster with extensive previous experience in laparoscopic surgery and adequate training in pancreatic surgery [4]. Additionally, high-quality surgical performance and low conversion rates are best achievable in high-volume centers [5].

Keywords

Laparoscopy Pancreas Pancreatoduodenectomy 

Supplementary material

Video 24.1

Total laparoscopic duodenopancreatectomy (MP4 307260 kb)

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  • Maurice J. W. Zwart
    • 1
  • Thijs de Rooij
    • 1
  • Olivier R. C. Busch
    • 1
  • Michael F. Gerhards
    • 2
  • Sebastiaan Festen
    • 2
  • Marc G. H. Besselink
    • 1
    Email author
  1. 1.Department of SurgeryAcademic Medical CenterAmsterdamThe Netherlands
  2. 2.Department of SurgeryOLVG HospitalAmsterdamThe Netherlands

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