Application and prospect of laparoscopic pancreaticoduodenectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

GONG Chenggong ,  HUANG Mingwen

Department of Hepatobiliary Surgery, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, P. R. China;

Corresponding?author：

HUANG Mingwen, Email: jxnchmw@126.com

Keywords：

pancreaticoduodenectomy; laparoscope; tumor; prognosis

DOI：

10.7507/1007-9424.202005053

Video：

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Objective To summarize the application status and prospect of laparoscopic pancreaticoduodenectomy (LPD).Method The relevant literatures about studies of LPD at home and abroad were reviewed.Results LPD was a difficult operation, mainly suitable for pancreatic head and periampullary benign and malignant tumors. With the development of laparoscopic techniques in recent years, LPD combined the superior mesenteric vein and portal vein resection and reconstruction, or combined multi-visceral resection was feasible, but the survival benefit of LPD with arterial resection and reconstruction and extended lymph node dissection remained to be discussed. At present, there was no clear requirement on the way to reconstruct the pancreatic fluid outflow tract, but the pancreaticojejunostomy for digestive tract reconstruction was chose by the most surgeons. The most studies had confirmed that LPD was minimally invasive and had a short-term prognosis that was not inferior to that of open pancreaticoduodenectomy. However, the results of large sample analysis about long-term survival rate and oncology results were lacking, so it was difficult to judge the advantages and disadvantages of long-term prognosis of the two methods.Conclusions LPD is a safe, feasible, reasonable, and effective surgical method. With improvement of laparoscopic technology, LPD is expected to become a standard operation method for treatment of pancreatic head cancer and periampullary carcinoma, and oncology benefits of LPD will be further confirmed in future by large-sample clinical randomized control trials and studies of long-term prognosis follow-up.

Citation： GONG Chenggong, HUANG Mingwen. Application and prospect of laparoscopic pancreaticoduodenectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2021, 28(3): 397-403. doi: 10.7507/1007-9424.202005053 Copy

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2. Kamarajah SK, Bundred JR, Marc OS, et al. A systematic review and network meta-analysis of different surgical approaches for pancreaticoduodenectomy. HPB (Oxford), 2020, 22(3): 329-339.
3. Torphy RJ, Friedman C, Halpern A, et al. Comparing short-term and oncologic outcomes of minimally invasive versus open pancreaticoduodenectomy across low and high volume centers. Ann Surg, 2019, 270(6): 1147-1155.
4. Tran TB, Dua MM, Worhunsky DJ, et al. The first decade of laparoscopic pancreaticoduodenectomy in the United States: costs and outcomes using the nationwide inpatient sample. Surg Endosc, 2016, 30(5): 1778-1783.
5. Sharpe SM, Talamonti MS, Wang CE, et al. Early national experience with laparoscopic pancreaticoduodenectomy for ductal adenocarcinoma: a comparison of laparoscopic pancreaticoduodenectomy and open pancreaticoduodenectomy from the National Cancer Data Base. J Am Coll Surg, 2015, 221(1): 175-184.
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7. Boggi U, Amorese G, Vistoli F, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc, 2015, 29(1): 9-23.
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9. Correa-Gallego C, Dinkelspiel HE, Sulimanoff I, et al. Minimally-invasive vs open pancreaticoduodenectomy: systematic review and meta-analysis. J Am Coll Surg, 2014, 218(1): 129-139.
10. 中華醫學會外科學分會胰腺外科學組, 中國醫療保健國際交流促進會胰腺病分會胰腺微創治療學組, 中國研究型醫院學會胰腺疾病專業委員會胰腺微創學組, 等. 腹腔鏡胰十二指腸切除手術專家共識(附: 手術流程與主要步驟). 中華外科雜志, 2017, 55(5): 335-339.
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18. Tempero MA, Malafa MP, Al-Hawary M, et al. Pancreatic adenocarcinoma, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw, 2017, 15(8): 1028-1061.
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27. Ome Y, Hashida K, Yokota M, et al. Laparoscopic radical antegrade modular pancreatosplenectomy for left-sided pancreatic cancer using the ligament of Treitz approach. Surg Endosc, 2017, 31(11): 4836-4837.
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29. 林榮貴, 黃鶴光, 陳燕昌, 等. 腹腔鏡胰十二指腸切除術行前入路靜脈優先聯合右后入路動脈優先切除鉤突35例分析. 中國實用外科雜志, 2018, 38(5): 560-563.
30. 金鋼, 鄭楷煉. 胰十二指腸切除術手術入路探討與評價. 中國實用外科雜志, 2016, 36(8): 829-834.
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