title: A totally laparoscopic pylorus-preserving pancreaticoduodenectomy and reconstruction.
abstract: Although many reports have described laparoscopic pancreatic surgery, laparoscopic pancreaticoduodenectomy (PD) has not been widely employed because of technical difficulties. This paper describes a totally laparoscopic pylorus-preserving PD performed for an intraductal papillary-mucinous neoplasm. After the laparoscopic resection, an end-to-side pancreaticojejunostomy including duct-to-mucosa anastomosis without a stenting tube, an approximation of the pancreas stump and jejunal wall, an end-to-side hepaticojejunostomy, and an end-to-side duodenojejunostomy were performed intracorporeally. The patient recovered without any complications and was discharged on the 14th postoperative day. The surgical margin was free of neoplastic changes. Although the experience is limited and the appropriate indications must await future studies, this case indicates that a laparoscopic pylorus-preserving PD can be feasible, safe, and effective in highly selected patients.
authors.affiliation: Division of Gastroenterological Surgery, Chiba Cancer Center Hospital, 666-2 Nitona-cho, Chuo-ku, Chiba 260-8717, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Cho
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Matsuo
authors.initials: M
authors.lastname: Nagata
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Takiguchi
authors.forename: Hideaki
authors.initials: H
authors.lastname: Shimada
authors.forename: Osamu
authors.initials: O
authors.lastname: Kainuma
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Souda
authors.forename: Hisashi
authors.initials: H
authors.lastname: Gunji
authors.forename: Akinari
authors.initials: A
authors.lastname: Miyazaki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Ikeda
authors.forename: Tomoko
authors.initials: T
authors.lastname: Tohma