Current status of laparoscopic pancreaticoduodenectomy and pancreatectomy.
This review describes the recent advances in, and current status of, minimally invasive pancreatic surgery (MIPS). Typical MIPS procedures are laparoscopic pancreaticoduodenectomy (LPD), laparoscopic distal pancreatectomy (LDP), laparoscopic central pancreatectomy (LCP), and laparoscopic total pancreatectomy (LTP). Some retrospective studies comparing LPD or LDP and open procedures have demonstrated the safety and feasibility as well as the intraoperative outcomes and postoperative recovery of these procedures. In contrast, LCP and LTP have not been widely accepted as common laparoscopic procedures owing to their complicated reconstruction and limited indications. Nevertheless, our concise review reveals that LCP and LTP performed by expert laparoscopic surgeons can result in good short-term and long-term outcomes. Moreover, as surgeons' experience with laparoscopic techniques continues to grow around the world, new innovations and breakthroughs in MIPS will evolve. Well-designed and suitably powered randomized controlled trials of LPD, LDP, LCP, and LTP are now warranted to demonstrate the superiority of these procedures.
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan. Electronic address: aumemura@iwate-med.ac.jp.
Akira
A
Umemura
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Hiroyuki
H
Nitta
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Takeshi
T
Takahara
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Yasushi
Y
Hasegawa
Department of Surgery, Iwate Medical University, Morioka, Iwate 020-8505, Japan.
Akira
A
Sasaki
D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000401:mortality; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D010180:Pancreatectomy / Q000379:methods* / Q000401:mortality; D010190:Pancreatic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods* / Q000401:mortality; D011183:Postoperative Complications / Q000401:mortality / Q000503:physiopathology; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
laparoscopic central pancreatectomy; laparoscopic distal pancreatectomy; laparoscopic pancreaticoduodenectomy; laparoscopic total pancreatectomy; postoperative pancreatic fistula