[The laparoscopic pancreas resection].
Laparoscopic surgery of the pancreas has been used for diagnostic but also for therapeutic purposes in increasing number. Case reports and multicenter studies summarizing the European and world wide experience have been published recently. The results show that laparoscopic surgery can be used for tumor staging of pancreatic cancer but also for the treatment of acute necrotizing pancreatitis and treatment of chronic pancreatitis, benign cystic lesions and solid tumors. In particular left sided pancreatic resection (90 % of the cases) is the preferred approach delivering good results. Recent studies show that the conversion rate is 14 % and mortality can be as low as 0 %. The reoperation rate is 6.3 % and the fistula formation is 17 % which is comparable to the results of open pancreatic surgery. The postoperative hospital stay seems to be limited to a mean of 7 days as compared to pancreatic surgery in the open abdomen. The laparoscopic Whipple resection with less than 3 % of the cases in the literature remains the exception.
Hesse
U
U
Klinik für Allgemein-, Viszeral- und Unfallchirurgie, Klinikum Stuttgart, Krankenhaus Bad Cannstatt. uhesse@kbc-intern.de
D006801:Humans; D007340:Insulinoma / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D015337:Multicenter Studies as Topic; D010043:Outcome and Process Assessment, Health Care; D010179:Pancreas / Q000473:pathology; D010180:Pancreatectomy / Q000379:methods*; D010181:Pancreatic Cyst / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D010190:Pancreatic Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D013528:Surgical Staplers; D015996:Survival Rate