Laparoscopic Pancreatoduodenectomy:safety and Efficacy of Radical Resection

Aim: To prove that radical laparoscopic pancreatoduodenectomy for malignancy can be safely performed, adhering to sound oncological principles. Methods: From March 1998 to January 2008, we retrospectively reviewed 52 patients undergoing laparoscopic pancreatoduodenectomy with nodal clearance for malignancy, and present a step-by-step video demonstration. Results: Mean age was 62 years and the types were ampullary, distal CBD, pancreatic head and duodenal carcinoma. Postoperative morbidity was 28.5%. Overall follow up rate was 95.1%, metastasis occurred in 2 cases, local recurrence in 1 case, perioperative mortality was 2.38%, conversion rate was 2% and tumor-free margins in 2% of cases. Mean number of nodes harvested was 5 and was positive in 12% of cases. The 5-year overall actuarial survival rate was 33.27%. Conclusion: It is known that radical resection prolongs overall survival. Based on our study, laparoscopic pancreatoduodenectomy with standard lymphadenectomy (clearance of common hepatic nodes, nodes along portal vein, superior mesenteric artery and vein) is safe, effective and provides all the benefits of minimally invasive surgery while maintaining oncological principles.


Session: Podium Video Presentation

Program Number: V045

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