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Laparoscopic Whipple procedure: review of the literature

  • Topics
  • Evolution and challenge in endoscopic HBP surgery
  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery

Abstract

Introduction

Laparoscopic pancreatic surgery represents one of the most advanced applications for laparoscopic surgery currently in use. In the past, minimally invasive techniques were only used for diagnostic laparoscopy, staging of pancreatic cancer, and palliative procedures for unresectable pancreatic cancer. With new advances in technology and instrumentation, some sophisticated procedures are currently available, such as the Whipple procedure, one of the most sophisticated applications of minimally invasive surgery.

Materials and methods

A review of the literature shows that 146 laparoscopic Whipple procedures have been published worldwide since 1994. The authors analyzed blood loss, mean operating time, hospital stay, conversion rate, mean age, mortality rate, lymph nodes in the pathologic findings, follow up, and complications.

Results

Mean age was 59.1 years; mean operating time was 439 min. The average blood loss for the reviewed literature was 143 mL; median hospital stay was 18 days; conversion rate was 46%; number of lymph nodes in the pathologic findings was 19; and mortalities related to the procedure was low, 2 patients (1.3%) and the complication rate was 16% (23/46 patients). Complications included 2 hemorrhages, 4 bowel obstructions, 1 stress ulcer, 1 delay of gastric emptying, 4 pneumonias, and 11 leaks.

Conclusion

This review demonstrates that the laparoscopic Whipple procedure is not only feasible but also safe, with low mortality and acceptable rates of complications.

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Authors and Affiliations

  1. Department of Surgery, Mount Sinai Medical Center, 4300 Alton Road, Miami Beach, FL, 33140, USA

    Michel Gagner

  2. Department of Surgery, Hospital Nacional Prof. A. Posadas. Haedo, Buenos Aires, Argentina

    Mariano Palermo

Authors
  1. Michel Gagner
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  2. Mariano Palermo
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Corresponding author

Correspondence to Michel Gagner.

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Gagner, M., Palermo, M. Laparoscopic Whipple procedure: review of the literature. J Hepatobiliary Pancreat Surg 16, 726–730 (2009). https://doi.org/10.1007/s00534-009-0142-2

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  • DOI: https://doi.org/10.1007/s00534-009-0142-2

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