title: [Laparoscopic pancreatic resection].
abstract: OBJECTIVE
  Despite being technically challenging, laparoscopic surgical procedures are increasingly being used also in pancreatic surgery. This review attempts to evaluate these procedures based on the currently available literature against the background of the high mortality of pancreatic surgery observed nationwide and the as yet unclear oncological validation of these procedures.
  
  
  METHODS
  Recently published retrospective cohort and register trials have evaluated not only perioperative outcome but also long-term survival after laparoscopic pancreatic resection.
  
  
  CONCLUSIONS
  Laparoscopic interventions are increasingly being used for treatment of malignant tumors of the pancreas. The advantages of laparoscopy, such as less intraoperative blood loss, reduced postoperative pain and a shorter duration of hospital stay, have all been demonstrated in retrospective trials. Equivalent long-term survival after oncological laparoscopic pancreatic surgery compared to open procedures was also observed in these trials; however, mortality even after laparoscopic pancreatic surgery was found to be significantly increased in low-volume centers. Prospective trials are still needed to prove adequate oncological treatment. Laparoskopische Verfahren haben sich in den letzten Jahren in fast allen Bereichen der Chirurgie quasi zum Standard entwickelt und werden von Patienten zunehmend nachgefragt. Die kosmetischen Ergebnisse sind deutlich besser als bei konventionellem Vorgehen und sie reduzieren unter anderem den postoperativen Schmerz, Schmerzmittelbedarf sowie den Krankenhausaufenthalt [29]. Daher ist es wenig überraschend, dass minimal-invasive Verfahren auch bei technisch hochkomplexen Eingriffen, wie z. B. am Pankreas, zunehmend eingesetzt werden. Allerdings wird ihr Einsatz hier noch immer kontrovers diskutiert.
authors.affiliation: Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland.
authors.forename: D
authors.initials: D
authors.lastname: Bausch
authors.affiliation: Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Deutschland. Tobias.Keck@uksh.de.
authors.forename: T
authors.initials: T
authors.lastname: Keck
mesh_terms: D015331:Cohort Studies; D005858:Germany; D061847:Hospitals, High-Volume / Q000706:statistics & numerical data; D061846:Hospitals, Low-Volume / Q000706:statistics & numerical data; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D010180:Pancreatectomy / Q000295:instrumentation / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis
keywords: Long term survival; Low volume hospitals; Minimally invasive surgical procedures; Oncologic treatment; Pancreatic surgery