Background: Laparoscopic pancreaticoduodenectomy (LPD) was still one of the most challenging endoscopic surgeries by far and there were still some technical problems to be resolved. In this study, we try to investigate the difficulties and countermeasures of the LPD.
Methods: A retrospective analysis was performed for the surgical techniques of the LPD carried out for 40 patients in our hospital from December 2009 to Jul 2015 and the clinical data such as operative time, intra-operative blood loss, numbers of scavenged lymph node and postoperative complications were collected.
Results among the 40 patients, 4 cases were converted to laparotomy and the other 36 cases were successfully completed the surgery. The mean operative time was 390±89min and the mean operative blood loss was 320±205ml. the edges of all samples were tumor-negative and the average scavenged lymph nodes were 15.8 ± 6.5 pieces. postoperative complicating pulmonary infection in 1 case, while was cured after strengthened the anti-infection; incision mal-healing in 1 case and was cured by the 2nd-stage suture; seroperitoneum accompanied with infection in 1 case and was performed the re-operative drainage; bile leakage in 3 cases and were cured after drainage; pancreatic leakage in 5 cases, among which 1 case developed the secondary intra-abdominal bleeding, and was re-operated to stop the bleeding, the other case was cured after the drainage. Delayed intra-abdominal bleeding in 1 case, which was caused by the irruption of hepatic artery and was cured with re-operation.
Conclusion: The application of appropriate surgical approach, improvement of the resection of UP and modification of the pancreaticojejunostomy (PJ) could make the LPD easier and safer.
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