title: Laparoscopic pancreaticoduodenectomy combined with minilaparotomy.
abstract: Laparoscopic pancreatic surgery is evolving rapidly; however, the surgical treatment of periampullary tumors is still fraught with challenges, such as technical difficulty and the appropriateness of oncologic treatment for these patients. We describe how we performed laparoscopic pancreaticoduodenectomy (LPD) combined with minilaparotomy successfully in six consecutive patients. This procedure consisted of two surgical phases: safe laparoscopic surgery, including the Kocher maneuver, tunneling behind the pancreatic neck, and dissecting along the uncinate process with magnified vision; and a secure open approach with complete skeletonization of the hepatoduodenal ligament and alimentary tract reconstruction, performed similarly to conventional pancreaticoduodenectomy, under direct visualization through the minilaparotomy. By performing this procedure, we combined a safe and secure minilaparotomy approach under direct vision with a less invasive laparoscopic approach providing a magnified image. Our experience demonstrates that LPD combined with minilaparotomy is technically feasible for selected patients with periampullary tumors.
authors: Department of Surgical Oncology, Hokkaido University Graduate School of Medicine, N-15, W-7, Kita-ku, Sapporo, Hokkaido, 060-8648, Japan. onsuzuki@tkeijinkai.gr.jp
authors: On
authors: O
authors: Suzuki
authors: Satoshi
authors: S
authors: Kondo
authors: Satoshi
authors: S
authors: Hirano
authors: Eiichi
authors: E
authors: Tanaka
authors: Kentaro
authors: K
authors: Kato
authors: Takahiro
authors: T
authors: Tsuchikawa
authors: Tomoyuki
authors: T
authors: Yano
authors: Keisuke
authors: K
authors: Okamura
authors: Toshiaki
authors: T
authors: Shichinohe
mesh_terms: D000368:Aged; D002277:Carcinoma / Q000601:surgery*; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D016609:Neoplasms, Second Primary / Q000601:surgery; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods*; D011028:Pneumoperitoneum, Artificial; D013274:Stomach Neoplasms / Q000601:surgery