PMID: 26797843Jan 23, 2016Paper

Laparoscopic pancreaticoduodenectomy: right-inferior-posterior "artery first" approach

Zhonghua wei chang wai ke za zhi = Chinese journal of gastrointestinal surgery
Xiaoming WangMeng Han

Abstract

To discuss the application of right-inferior-posterior "artery first" approach in laparoscopic pancreaticoduodenectomy. Clinical data of 17 patients who underwent laparoscopic pancreaticoduodenectomy through right-inferior-posterior "artery first" approach in our department from February 2014 to April 2015 were retrospectively analyzed. The operation began at the inferior flexure of duodenum. After entering the Toldt's space, the left renal vein (LRV) was revealed and the root of superior mesenteric artery (SMA) was exposed just above the LRV. SMA was dissected along its trunk till the horizontal part of duodenum. Of these 17 cases, adenocarcinoma of pancreatic head was observed in 5 cases, adenosquamous carcinoma in 2 cases, mucinous cycstic neoplasm in 1 case, adenocarcinoma of lower common bile duct in 4 cases, and duodenal papilla cancer in 5 cases. Fifteen cases were accomplished successfully with laparoscopy and 2 cases were converted to open approach. The average operating time was (320±85) min and mean intraoperative blood loss was (305±175) ml. The cutting margins were tumor negative in all the patients. The average number of harvested lymph node was 15.4±6.5. Postoperative complication occurred in 5 cases. Two cases o...Continue Reading

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