Experience of Laparoscopic Pancreaticoduodenectomy in Treatment of 45 Patients with Periampullary Diseases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

 ZHANGHua , WANGMing-jun , WANGXin , ALi ,  PENGBing

Department of Hepatopancreatobiliary Surgery, West China Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China;

Corresponding?author：

PENGBing, Email: pengbing84@hotmail.Com

Keywords：

Periampullary disease; Laparoscope; Pancreaticoduodenectomy; Pylorus preserving pancreaticoduodenectomy

DOI：

10.7507/1007-9424.20140226

Video：

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Objective To investigate the feasibility and security of laparoscopic Whipple pancreaticoduodenectomy(LPD)or laparoscopic pylorus preserving pancreaticoduodenectomy(LPPPD)for the patients with periampullary diseases, estimate the ratio of postoperative complications between LPD and LPPPD. Methods Fourty-five patients who underwent the LPD or LPPPD from January 2010 to March 2014 were reviewed retrospectively. These patients were divided into LPD group and LPPPD group basing on the Whipple or polyrus preservation. Results Among these 45 patients, 25 patients were performed the LPD, the other 20 patients were performed the LPPPD. There were 25(55.56%)complications after operation, including 10 cases of pancreatic fistula, 1 case of bile leakage, 6 cases of delayed gastric emptying, 3 cases of infection, 2 cases of stomach intestine stomatorrhagia, 1 case of mesenteric venous thrombosis, 1 case of ascites, 1 case of chylous fistula. The complication rate had no significant difference between two groups. One patient died after operation in the LPPPD group. Conclusion Laparoscopic pancreaticoduodenectomy is safe and feasible in the treatment of periampullary diseases, the LPPPD could partly prevent the occurrence of reflux of the digestive juice following the resection of pylorus and improve the quality of life.

Citation： ZHANGHua, WANGMing-jun, WANGXin, ALi, PENGBing. Experience of Laparoscopic Pancreaticoduodenectomy in Treatment of 45 Patients with Periampullary Diseases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2014, 21(8): 940-945. doi: 10.7507/1007-9424.20140226 Copy

1.	Tran KT, Smeenk HG, van Eijck CH, et al. Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors[J]. Ann Surg, 2004, 240(5): 738-745.
2.	劉戰培, 蒲青凡, 周勇. 233例胰十二指腸切除術后并發癥及死亡危險因素多因素分析[J].中國普外基礎與臨床雜志, 2008, 15(3): 195-200.
3.	Alsaif F. Pylorus preserving pancreaticoduodenectomy for periampullary carcinoma, is it a good option?[J]. Saudi J Gastroenterol, 2010, 16(2): 75-78.
4.	Kohsari MR, Riazi H, Akbar MH. Outcome of pancreaticoduodenectomy: comparing the classic Whipple with pyloric preservation[J]. Saudi J Gastroenterol, 2004, 10(3): 144-149.
5.	張超, 龔昭, 夏輝.腹腔鏡與開腹胰十二指腸切除術效果比較[J].現代中西醫結合雜志, 2014, 23(7): 719-721.
6.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy[J]. Surg Endosc, 1994, 8(5): 408-410.
7.	盧榜裕, 陸文奇, 李杰, 等.電視腹腔鏡胰十二指腸切除術5例報告[J].中國微創外科雜志, 2005, 5(11): 877-879.
8.	袁濤, 鄧少麗, 顧紅光, 等. 156例胰十二指腸切除術臨床分析[J].中國現代醫學雜志, 2009, 19(19): 3035-3037.
9.	蔣金偉, 黃國強, 唐勇, 等. 68例胰十二指腸切除術后早期并發癥危險因素分析[J].重慶醫科大學學報, 2010, 35(3): 457-460.
10.	紀偉平, 邵卓, 沈力, 等.胰十二指腸切除術后乳糜漏的成因分析和治療手段[J].肝膽胰外科雜志, 2013, 26(1): 12-15.
11.	劉強.胰十二指腸切除術并發癥臨床分析[J].中外醫學研究, 2014, 12(13): 122-123.
12.	王志才.胰十二指腸切除61例臨床分析[J].臨床和實驗醫學雜志, 2007, 6(10): 111.
13.	Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience[J]. Arch Surg, 2010, 145(1): 19-23.
14.	周濤, 郝伏龍, 張偉.完全腹腔鏡與開腹手術行胰十二指腸切除的臨床效果比較[J].實用醫院臨床雜志, 2013, 10(4): 185-187.
15.	Adam U, Makowiec F, Riediger H, et al. Risk factors for complications after pancreatic head resection[J]. Am J Surg, 2004, 187(2): 201-208.
16.	吳傳有, 劉長安, 李生偉, 等.胰十二指腸切除術后胰瘺的預防[J].現代臨床醫學, 2014, 40(2): 86-88.
17.	Cameron JL. Whipple or pylorus preservation? A critical reappraisal and some new insights into pancreaticoduodenectomy[J]. Ann Surg, 2000, 231(3): 301-302.
18.	Kozuschek W. Cephalic duodenopancreatectomy with pylorus preservation. An experience of 52 surgically-treated cases[J]. Chirurgie, 1991, 117(5/6): 423-430.
19.	Karanicolas PJ, Davies E, Kunz R, et al. The pylorus: take it or leave it? Systematic review and meta-analysis of pylorus-preserving versus standard Whipple pancreaticoduodenectomy for pancreatic or periampullary cancer[J]. Ann Surg Oncol, 2007, 14(6): 1825-1834.
20.	Seiler CA, Wagner M, Bachmann T, et al. Randomized clinical trial of pylorus-preserving duodenopancreatectomy versus classical Whipple resection-long term results[J]. Br J Surg, 2005, 92(5): 547-556.
21.	Horstmann O, Markus PM, Ghadimi MB, et al. Pylorus preservation has no impact on delayed gastric emptying after pancreatic head resection[J]. Pancreas, 2004, 28(1): 69-74.
22.	Akizuki E, Kimura Y, Nobuoka T, et al. Prospective nonrandomized comparison between pylorus-preserving and subtotal stomachpreserving pancreaticoduodenectomy from the perspectives of DGE occurrence and postoperative digestive functions[J]. J Gastrointest Surg, 2008, 12(7): 1185-1192.
23.	Iqbal N, Lovegrove RE, Tilney HS, et al. A comparison of pancreaticoduodenectomy with pylorus preserving pancreaticoduodenectomy: a meta-analysis of 2822 patients[J]. Eur J Surg Oncol, 2008, 34(11): 1237-1245.
24.	Zerbi A, Balzano G, Patuzzo R, et al. Comparison between pylorus-preserving and Whipple pancreatoduodenectomy[J]. Br J Surg, 1995, 82(7): 975-979.
25.	Yamaguchi K, Kishinaka M, Nagai E, et al. Pancreatoduodenectomy for pancreatic head carcinoma with or without pylorus preservation[J]. Hepatogastroenterology, 2001, 48(41): 1479-1485.
26.	黃澤堅, 張磊, 彭孝雄, 等.降低胰十二指腸切除術后外科并發癥的臨床體會[J].嶺南現代臨床外科, 2010, 10(4): 256-258.
27.	Bell RH Jr. Pancreaticoduodenectomy with or without pylorus preservation have similar outcomes[J]. Cancer Treat Rev, 2005, 31(4): 328-331.
28.	Mosca F, Giulianotti PC, Balestracci T, et al. Long-term survival in pancreatic Cancer: pylorus-preserving versus Whipple pancreatoduodenectomy[J]. Surgery, 1997, 122(3): 553-566.

1. Tran KT, Smeenk HG, van Eijck CH, et al. Pylorus preserving pancreaticoduodenectomy versus standard Whipple procedure: a prospective, randomized, multicenter analysis of 170 patients with pancreatic and periampullary tumors[J]. Ann Surg, 2004, 240(5): 738-745.
2. 劉戰培, 蒲青凡, 周勇. 233例胰十二指腸切除術后并發癥及死亡危險因素多因素分析[J].中國普外基礎與臨床雜志, 2008, 15(3): 195-200.
3. Alsaif F. Pylorus preserving pancreaticoduodenectomy for periampullary carcinoma, is it a good option?[J]. Saudi J Gastroenterol, 2010, 16(2): 75-78.
4. Kohsari MR, Riazi H, Akbar MH. Outcome of pancreaticoduodenectomy: comparing the classic Whipple with pyloric preservation[J]. Saudi J Gastroenterol, 2004, 10(3): 144-149.
5. 張超, 龔昭, 夏輝.腹腔鏡與開腹胰十二指腸切除術效果比較[J].現代中西醫結合雜志, 2014, 23(7): 719-721.
6. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy[J]. Surg Endosc, 1994, 8(5): 408-410.
7. 盧榜裕, 陸文奇, 李杰, 等.電視腹腔鏡胰十二指腸切除術5例報告[J].中國微創外科雜志, 2005, 5(11): 877-879.
8. 袁濤, 鄧少麗, 顧紅光, 等. 156例胰十二指腸切除術臨床分析[J].中國現代醫學雜志, 2009, 19(19): 3035-3037.
9. 蔣金偉, 黃國強, 唐勇, 等. 68例胰十二指腸切除術后早期并發癥危險因素分析[J].重慶醫科大學學報, 2010, 35(3): 457-460.
10. 紀偉平, 邵卓, 沈力, 等.胰十二指腸切除術后乳糜漏的成因分析和治療手段[J].肝膽胰外科雜志, 2013, 26(1): 12-15.
11. 劉強.胰十二指腸切除術并發癥臨床分析[J].中外醫學研究, 2014, 12(13): 122-123.
12. 王志才.胰十二指腸切除61例臨床分析[J].臨床和實驗醫學雜志, 2007, 6(10): 111.
13. Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience[J]. Arch Surg, 2010, 145(1): 19-23.
14. 周濤, 郝伏龍, 張偉.完全腹腔鏡與開腹手術行胰十二指腸切除的臨床效果比較[J].實用醫院臨床雜志, 2013, 10(4): 185-187.
15. Adam U, Makowiec F, Riediger H, et al. Risk factors for complications after pancreatic head resection[J]. Am J Surg, 2004, 187(2): 201-208.
16. 吳傳有, 劉長安, 李生偉, 等.胰十二指腸切除術后胰瘺的預防[J].現代臨床醫學, 2014, 40(2): 86-88.
17. Cameron JL. Whipple or pylorus preservation? A critical reappraisal and some new insights into pancreaticoduodenectomy[J]. Ann Surg, 2000, 231(3): 301-302.
18. Kozuschek W. Cephalic duodenopancreatectomy with pylorus preservation. An experience of 52 surgically-treated cases[J]. Chirurgie, 1991, 117(5/6): 423-430.
19. Karanicolas PJ, Davies E, Kunz R, et al. The pylorus: take it or leave it? Systematic review and meta-analysis of pylorus-preserving versus standard Whipple pancreaticoduodenectomy for pancreatic or periampullary cancer[J]. Ann Surg Oncol, 2007, 14(6): 1825-1834.
20. Seiler CA, Wagner M, Bachmann T, et al. Randomized clinical trial of pylorus-preserving duodenopancreatectomy versus classical Whipple resection-long term results[J]. Br J Surg, 2005, 92(5): 547-556.
21. Horstmann O, Markus PM, Ghadimi MB, et al. Pylorus preservation has no impact on delayed gastric emptying after pancreatic head resection[J]. Pancreas, 2004, 28(1): 69-74.
22. Akizuki E, Kimura Y, Nobuoka T, et al. Prospective nonrandomized comparison between pylorus-preserving and subtotal stomachpreserving pancreaticoduodenectomy from the perspectives of DGE occurrence and postoperative digestive functions[J]. J Gastrointest Surg, 2008, 12(7): 1185-1192.
23. Iqbal N, Lovegrove RE, Tilney HS, et al. A comparison of pancreaticoduodenectomy with pylorus preserving pancreaticoduodenectomy: a meta-analysis of 2822 patients[J]. Eur J Surg Oncol, 2008, 34(11): 1237-1245.
24. Zerbi A, Balzano G, Patuzzo R, et al. Comparison between pylorus-preserving and Whipple pancreatoduodenectomy[J]. Br J Surg, 1995, 82(7): 975-979.
25. Yamaguchi K, Kishinaka M, Nagai E, et al. Pancreatoduodenectomy for pancreatic head carcinoma with or without pylorus preservation[J]. Hepatogastroenterology, 2001, 48(41): 1479-1485.
26. 黃澤堅, 張磊, 彭孝雄, 等.降低胰十二指腸切除術后外科并發癥的臨床體會[J].嶺南現代臨床外科, 2010, 10(4): 256-258.
27. Bell RH Jr. Pancreaticoduodenectomy with or without pylorus preservation have similar outcomes[J]. Cancer Treat Rev, 2005, 31(4): 328-331.
28. Mosca F, Giulianotti PC, Balestracci T, et al. Long-term survival in pancreatic Cancer: pylorus-preserving versus Whipple pancreatoduodenectomy[J]. Surgery, 1997, 122(3): 553-566.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Experience of Laparoscopic Pancreaticoduodenectomy in Treatment of 45 Patients with Periampullary Diseases

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