Experience in clinical application of laparoscopic pancreaticoduodenectomy: a report of 22 cases
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R657.5

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    Abstract:

    Objective: To evaluate the feasibility, safety and surgical skills of complete laparoscopic pancreaticoduodenectomy (CLPD).    
    Methods: The clinical data of 22 patients undergoing CLPD in the Department of Hepatobiliary Surgery of Shanxi Provincial People’s Hospital from January 2015 to March 2019 were retrospectively analyzed. All patients underwent CLPD by using the conventional five-hole method, and pancreaticojejunostomy by using “pancreatic duct-jejunum anastomosis plus closed-loop suture running through the cut end of the pancreas to the seromuscular layer of the jejunum”. 
    Results: CLPD was completed in all the 22 patients, without any open conversion. The average operative time was (655±65.66) min, average intraoperative blood loss was (364±177.76) mL, and 12 cases received an intraoperative blood transfusion, with an average volume of (533±188.56) mL. The incidence of overall postoperative complications was 31.8% (7/22), including grade A pancreatic fistula in 2 cases (9.0%), grade B pancreatic fistula in 1 case (4.5%), bile leakage in 1 case (4.5%), intraperitoneal hemorrhage, in 1 case (4.5%), anastomotic bleeding in 1 case (4.5%) and pulmonary infection in 1 case (4.5%), respectively. Postoperative follow-up was conducted for 3 42 months, 2 patients died from tumor recurrence, and the other 20 patients were alive without recurrence or metastasis.
    Conclusion: CLPD is safe and feasible and also has the advantages of less trauma and quick postoperative recovery. This procedure can be further generalized with the constant accumulation of experience.

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ZHANG Zhiyong, CHANG Hulin, HAI Jun, WU Xiaorong, LI Xianli, DU lixue. Experience in clinical application of laparoscopic pancreaticoduodenectomy: a report of 22 cases[J]. Chin J Gen Surg,2019,28(9):1075-1081.
DOI:10.7659/j. issn.1005-6947.2019.09.007

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History
  • Received:March 01,2019
  • Revised:August 19,2019
  • Adopted:
  • Online: September 25,2019
  • Published: