Laparoscopic Pancreaticoduodenectomy: A Report of 125 Cases in a Single Institute

Wei-Wei Jin, MD1, Xiao-Wu Xu, MD2, Yi-Ping Mou, MD, FACS2, Yu-Chen Zhou2, Chao-Jie Huang2, Chao Lu1, Rong-Gao Cheng1, Jia-Yu Zhou1. 1Medical School, Zhejiang Universtity, 2Divison of Gastroentropancreas, Department of General Surgery, Zhejiang Provincial People’s Hospital

Background   Laparoscopic pancreaticoduodenectomy is still a difficult procedure for most surgeons and is uncertainty in safety, feasibility and oncologic outcomes. This study aims to present a big series of laparoscopic pancreaticoduodenectomy in a single institution.

Methods From September 2012 to August 2015, there were 125 patients undergoing laparoscopic pancreaticoduodenectomy in a single institution. The blood loss, operative time, postoperative morbidity, length of postoperative hospital stay and 30-day mortality were analyzed.

Results There were 116 patients undergoing pure laparoscopic pancreaticoduodenectomy and the other 9 patients with laparoscopic assisted procedure. The mean age was (60.24±12.21) years old and BMI was (23.21±3.54)kg/m2. The operative time was (354.44±62.93) minutes and the blood loss was (176.45±142.54) ml. The rate of overall postoperative complications was 34.4% (43/125), with 9.6% (12/125) of grade B or C pancreatic fistula and 9.6% (12/125) of postoperative bleeding. The mean postoperative hospital stay was (16.71±9.88) days. There was no 30-day mortality. The mean size of tumors was (3.92±2.59)cm. The number of lymph nodes retrieved was (20.95±11.97). There were 85 patients with malignance, including pancreatic adenocarcinoma(n=37), cholangiocarcinoma(n=14) and ampullary adenocarcinoma (n=34), the tumor size was (2.63±1.41) cm, (2.81±1.24)cm and (3.12±1.93)cm, respectively. The number of lymph nodes retrieved was (22.04±11.77), (20.81±9.19) and (23.47±12.31), respectively. The rate of R0 resection was 94.8% (2/28), 100% and 100%, respectively.

Conclusion Laparoscopic pancreaticoduodenectomy is technically safe and feasible in skilled hands, and can achieve good oncological outcomes.

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