title: Learning Curve for Laparoscopic Pancreaticoduodenectomy: A Single Surgeon's Experience with Consecutive Patients.
abstract: OBJECTIVE
  Laparoscopic pancreaticoduodenectomy (LPD) is regarded as one of the most complex surgical procedures. The aim of this study was to examine a single surgeon's learning curve for LPD in consecutive cases.
  
  
  METHODS
  Thirty consecutive patients who underwent an LPD by the same single surgeon were divided into three groups (A, B, and C; 10 cases each). Postoperative complications, operative time, and blood loss for each group were compared.
  
  
  RESULTS
  There were no significant differences in the occurrence of postoperative complications among the groups. There were significant differences in both operative time and blood loss between groupA (mean operative time, 796.8 mm; mean blood loss 546.2 mL) and group B (mean operative time, 563.9 mm; mean blood loss 242.0 mL), and between groups A and C (mean operative time, 515.8 mm; mean blood loss 283.0 mL). Regarding operative time and blood loss, the surgeon reached a learning curve plateau after 10 cases/LPD procedures.
  
  
  CONCLUSIONS
  LPD is a feasible and safe surgical procedure with a steep learning curve when performed by a surgeon who is experience in open PD, and LPD provides the advantages that would be expected from a minimally invasive surgery.
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.forename: Amane
authors.initials: A
authors.lastname: Kitasato
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Adachi
authors.forename: Takayuki
authors.initials: T
authors.lastname: Tanaka
authors.forename: Masataka
authors.initials: M
authors.lastname: Hirabaru
authors.forename: Hajime
authors.initials: H
authors.lastname: Matsushima
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002983:Clinical Competence; D006801:Humans; D007564:Japan; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome