Minimally Invasive Surgical Approaches for Pancreatic Adenocarcinoma: Recent Trends.
BACKGROUND
Pancreatic resection for cancer represents a real challenge for every surgeon. Recent improvements in laparoscopic experience, minimally invasive surgical techniques and instruments make now the minimally invasive approach a real "triumph." There is no doubt that minimally invasive surgery has replaced with great success conventional surgery in many fields, including surgical oncology.


RESULTS
However, its progress in pancreatic resection for adenocarcinoma has been dramatically slow. Recent evidence supports the notion that minimally invasive distal pancreatectomy is safe and feasible and that is becoming the procedure of choice mainly for benign or low-grade malignant lesions in the distal pancreas. On the other side, minimally invasive pancreatoduodenectomy has not yet been widely accepted and there is enormous skepticism when applied for pancreatic head adenocarcinoma. In this review, we summarize the current evidence on the potential applications of minimally invasive surgical approaches for this aggressive, heterogeneous, and enigmatic type of cancer.


CONCLUSIONS
Moreover, the potential future applications of these approaches are discussed with the hope to improve the quality of life as well as the survival rates of pancreatic cancer patients.
Department of Surgery, School of Medicine, University of Ioannina, University Hospital of Ioannina, 451 10, Ioannina, Greece. georgiolianos@yahoo.gr.
Georgios D
GD
Lianos
Department of Gastroenterology, School of Medicine, University of Ioannina, University Hospital of Ioannina, 451 10, Ioannina, Greece.
Dimitrios K
DK
Christodoulou
Department of Gastroenterology, School of Medicine, University of Ioannina, University Hospital of Ioannina, 451 10, Ioannina, Greece.
Konstantinos H
KH
Katsanos
Department of Surgery, School of Medicine, University of Ioannina, University Hospital of Ioannina, 451 10, Ioannina, Greece.
Christos
C
Katsios
Department of Surgery, School of Medicine, University of Ioannina, University Hospital of Ioannina, 451 10, Ioannina, Greece.
Georgios K
GK
Glantzounis
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods / Q000639:trends*; D019060:Minimally Invasive Surgical Procedures / Q000379:methods / Q000639:trends; D060787:Neoplasm Grading; D059351:Organ Sparing Treatments / Q000009:adverse effects / Q000639:trends; D010179:Pancreas / Q000473:pathology / Q000601:surgery; D010180:Pancreatectomy / Q000379:methods / Q000639:trends*; D010190:Pancreatic Neoplasms / Q000401:mortality / Q000601:surgery*; D016577:Pancreaticoduodenectomy / Q000379:methods / Q000639:trends*; D011788:Quality of Life; D065287:Robotic Surgical Procedures / Q000379:methods / Q000639:trends; D013154:Spleen / Q000601:surgery; D015996:Survival Rate; D016896:Treatment Outcome
Guidelines; Laparoscopic pancreatectomy; Minimally invasive pancreatoduodenectomy; Pancreatic cancer; Robotic pancreatectomy