title: Laparoscopic Supracolic Pancreaticoduodenectomy: A Novel Technique For Complete Uncinate Process Resection.
abstract: BACKGROUND
  Laparoscopic pancreaticoduodenectomy represents one of the most advanced surgical approaches for periampullary and pancreatic head tumors. This article aims to describe the novel technique for complete resection of the uncinate process from supracolic compartment only and summarizes the results from our institute.
  
  
  METHODS
  Retrospective review of prospectively maintained database was performed for patients who underwent laparoscopic pancreaticoduodenectomy from April 2008 to March 2012 at our institute.
  
  
  RESULTS
  A total of 38 patients with a mean age of 56.5 years (range: 35-70) underwent laparoscopic pancreaticoduodenectomy with this novel approach. Complete resection of uncinate process was achieved in 33 (86.84%) patients. The mean total operative time and resection time was 231.70 mins (range: 210-450) and 116.50 mins (range: 80-250), respectively. The mean blood loss was 183 ml (range 60-340). Major perioperative morbidity included pancreatic anastomotic leak (n = 3), billiary leak (n = 1) and hemorrhage (n = 1). Mean hospital stay was 14 days (range: 12-25 days).
  
  
  CONCLUSIONS
  This novel supracolic approach for laparoscopic pancreaticoduodenectomy is feasible, safe and less time consuming. This technique can help achieving oncological outcomes comparable to those of the other techniques; though with the minimum invasion. This procedure can be performed conveniently by surgeons with substantial knowledge, experience and skills.
authors.forename: Shailesh
authors.initials: S
authors.lastname: Puntambekar
authors.forename: Rahul
authors.initials: R
authors.lastname: Kenawadekar
authors.forename: Archit
authors.initials: A
authors.lastname: Pandit
authors.forename: Akshay
authors.initials: A
authors.lastname: Nadkarni
authors.forename: Nasir Ahmad
authors.initials: NA
authors.lastname: Bhat
authors.forename: Saurabh
authors.initials: S
authors.lastname: Joshi
authors.forename: Geetanjali Agarwal
authors.initials: GA
authors.lastname: Joshi
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D016208:Databases, Factual; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome