title: Laparoscopic pancreatectomy: indications and outcomes.
abstract: The application of minimally invasive approaches to pancreatic resection for benign and malignant diseases has been growing in the last two decades. Studies have demonstrated that laparoscopic distal pancreatectomy (LDP) is feasible and safe, and many of them show that compared to open distal pancreatectomy, LDP has decreased blood loss and length of hospital stay, and equivalent post-operative complication rates and short-term oncologic outcomes. LDP is becoming the procedure of choice for benign or small low-grade malignant lesions in the distal pancreas. Minimally invasive pancreaticoduodenectomy (MIPD) has not yet been widely adopted. There is no clear evidence in favor of MIPD over open pancreaticoduodenectomy in operative time, blood loss, length of stay or rate of complications. Robotic surgery has recently been applied to pancreatectomy, and many of the advantages of laparoscopy over open surgery have been observed in robotic surgery. Laparoscopic enucleation is considered safe for patients with small, benign or low-grade malignant lesions of the pancreas that is amenable to parenchyma-preserving procedure. As surgeons' experience with advanced laparoscopic and robotic skills has been growing around the world, new innovations and breakthrough in minimally invasive pancreatic procedures will evolve.
authors.affiliation: Shuyin Liang, Usmaan Hameed, Shiva Jayaraman, Division of General Surgery, University of Toronto, Toronto, ON M6R1B5, Canada.
authors.forename: Shuyin
authors.initials: S
authors.lastname: Liang
authors.affiliation: Shuyin Liang, Usmaan Hameed, Shiva Jayaraman, Division of General Surgery, University of Toronto, Toronto, ON M6R1B5, Canada.
authors.forename: Usmaan
authors.initials: U
authors.lastname: Hameed
authors.affiliation: Shuyin Liang, Usmaan Hameed, Shiva Jayaraman, Division of General Surgery, University of Toronto, Toronto, ON M6R1B5, Canada.
authors.forename: Shiva
authors.initials: S
authors.lastname: Jayaraman
mesh_terms: D016063:Blood Loss, Surgical; D002983:Clinical Competence; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D059032:Learning Curve; D007902:Length of Stay; D010180:Pancreatectomy / Q000009:adverse effects / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000401:mortality*; D018579:Patient Selection; D011183:Postoperative Complications / Q000209:etiology; D012307:Risk Factors; D065287:Robotic Surgical Procedures; D012371:Robotics; D013997:Time Factors; D016896:Treatment Outcome
keywords: Distal pancreatectomy; Enucleation; Laparoscopy; Pancreaticoduodenectomy; Robotic pancreatectomy