Revista chilena de cirugía
versión On-line ISSN 0718-4026
JARUFE C, NICOLÁS et al. Totally laparoscopic pancreaticoduodenectomy: Surgical technique and initial experience. Rev Chil Cir [online]. 2009, vol.61, n.1, pp. 33-38. ISSN 0718-4026. http://dx.doi.org/10.4067/S0718-40262009000100006.
Introduction: Nowadays the utility of laparoscopic pancreatic surgery is accepted for a wide variety of indications. However pancreaticoduodenectomy has been considered beyond the possibilities of laparoscopy by the majority of surgeons. The objective of this report is to show our surgical technique and initial experience with totally laparoscopic pancreaticoduodenectomy. Material and Methods: Between november of 2007 and june of 2008, a laparoscopic technique was offered to patients with indication of pancreaticoduodenectomy for different pathologies. We describe the surgical technique, perioperative care, intraoperative complications, need for conversión to open technique, mortality, and early postoperative complications. Results: A total of three patients were subjected to laparoscopic pancreaticoduodenectomy. The surgical indication was an ampullar adenocarcinoma in a 52 years oíd woman, a pseudopapilar tumor of the pancreatic head in a 17 years oíd woman, and a duodenal gastrointestinal stromal tumor in a 63 years oíd man. There was no need for conversión to open technique. There was no mortality. The operative time ranged from 300 to 360 min. The first patient presented an upper gastrointestinal bleeding, from pancreatic anastomoses requiring surgical hemostasis. The last patient developed a self-limited biliary fístula, managed successfully with drains. The hospital stay varied from 8 to 25 days. Discussion: Totally laparoscopic pancreaticoduodenectomy is a feasible procedure, replicating the same steps of open surgery in a reasonable operative time, and with surgical results comparable with open technique.
Palabras clave : Laparoscopy; pancreaticoduodenectomy; Whipple procedure.