Difficulties and strategies of laparoscopic pancreaticoduodenectomy

doi:10.3877/cma.j.issn.1674-3946.2024.03.003

Abstract

Abstract:

In recent years, laparoscopic pancreaticoduodenectomy has rapidly developed. With the advancement of laparoscopic techniques, the indications for laparoscopic pancreaticoduodenectomy have gradually expanded. laparoscopic pancreaticoduodenectomy with vascular resection and reconstruction have been widely implemented in some major centers, and its safety has been confirmed. However, for some centers with less experience, laparoscopic pancreaticoduodenectomy remains a high-difficulty and high-risk surgery. The surgical challenges mainly consist of two parts: the difficulty of resection and the difficulty of gastrointestinal reconstruction. This article, combining the experience of our center, discusses the challenges and strategies of laparoscopic pancreaticoduodenectomy.

Key words: Pancreas, Laparoscopic Pancreaticoduodenectomy, Minimal Invasive Surgical Procedures

Huaizhi Wang, Pijiang Sun, Shang Cui. Difficulties and strategies of laparoscopic pancreaticoduodenectomy[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(03): 246-248.

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References 19

［1］	张太平，翁桂湖，刘悦泽. 不断推进中国腹腔镜胰腺癌手术规范化［J/CD］. 中华普外科手术学杂志（电子版），2023，17（02）: 120-123.
［2］	田锋，郭俊超. 中国微创技术在胰腺癌外科中的应用现状与展望［J/CD］. 中华普外科手术学杂志（电子版），2023，17（02）: 124-128.
［3］	王槐志，郭诗翔，谢彬. 中国胰十二指肠切除淋巴结清扫范围与注意事项［J/CD］. 中华普外科手术学杂志（电子版），2022，16（04）: 364-366.
［4］	牟一平，金巍巍. 腹腔镜胰十二指肠切除术：难点与对策［J］. 中国实用外科杂志，2022，42（05）: 491-493.
［5］	李国林，林青，郑上游，等. 程序化流程腹腔镜胰十二指肠切除术的初步探讨［J/CD］. 中华腔镜外科杂志（电子版），2018，11（02）: 85-89.
［6］	杨帆，刘亚辉，刘松阳，等. 完全腹腔镜“下入路，钩突优先，动脉先行”胰十二指肠切除术的临床应用［J］. 中国微创外科杂志，2018，18（10）: 908-910.
［7］	Sato T，Inoue Y，Oba A，et al. Laparoscopic dissection around the superior mesenteric artery by left posterior approach during pancreaticoduodenectomy［J］. Surg Endosc, 2023，37（11）: 8871-8878.
［8］	孙文兵，姚常玉，王劭宏. 肝右动脉变异及其外科意义［J］. 中华肝胆外科杂志，2020，26（05）: 321-325.
［9］	王子铭，张志忠，刘文生，等. 腹腔镜胰十二指肠切除术中胰背动脉的解剖观察及处理［J］. 腹腔镜外科杂志，2023，28（10）: 733-738,753.
［10］	Iede K，Nakao A，Oshima K，et al. Early ligation of the dorsal pancreatic artery with a mesenteric approach reduces intraoperative blood loss during pancreatoduodenectomy［J］. J Hepatobiliary Pancreat Sci，2018，25（7）: 329-334.
［11］	Jiang CY，Liang Y，Chen YT，et al. The anatomical features of dorsal pancreatic artery in the pancreatic head and its clinical significance in laparoscopic pancreatoduodenectomy［J］. Surg Endosc，2021，35（2）: 569-575.
［12］	Nakao A. Isolated pancreatectomy using mesenteric approach［J］. J Hepatobiliary Pancreat Sci，2022，29（3）: 293-300.
［13］	李征，虞先濬，徐晓武. 胰腺癌新辅助化疗后行腹腔镜胰十二指肠切除术的难点及对策［J］. 中国实用外科杂志，2022，42（05）: 526-528.
［14］	卓奇峰，刘梦奇，李征，等. 胰腺癌新辅助化疗后腹腔镜手术治疗的效果分析［J］. 中华外科杂志，2022, 60（02）: 134-139.
［15］	Nagakawa Y，Hosokawa Y，Sahara Y，et al. Approaching the superior mesenteric artery from the right side using the proximal-dorsal jejunal vein preisolation method during laparoscopic pancreaticoduodenectomy［J］. Surg Endosc，2018，32（9）: 4044-4051.
［16］	van den Broek BLJ，Zwart MJW，Bonsing BA，et al. Video Grading of Pancreatic Anastomoses During Robotic Pancreatoduodenectomy to Assess Both Learning Curve and the Risk of Pancreatic Fistula: A Post Hoc Analysis of the LAELAPS-3 Training Program［J］. Ann Surg，2023，278（5）: e1048-e1054.
［17］	Cai Y，Luo H，Li Y，et al. A novel technique of pancreaticojejunostomy for laparoscopic pancreaticoduodenectomy［J］. Surg Endosc, 2019，33（5）: 1572-1577.
［18］	Sun PJ，Yu YH，Li JW，Cui XJ. A Novel Anastomosis Technique for Laparoscopic Pancreaticoduodenectomy: Case Series of Our Center's Experience［J］. Front Surg，2021，8: 583671.
［19］	刘军，郑元文. 腹腔镜一针式降落伞胆肠吻合缝合方式的应用与探讨［J/CD］. 中华腔镜外科杂志（电子版），2020，13（06）: 328-331.

[1]	Qiong Gao, Zhongxia Sun, Ge Zhang, Min Wang, Zihang Xu, Jiateng Zhang, Tian'an Jiang. Causes and countermeasures of missed diagnosis and misdiagnosis of pancreatic space-occupying lesions by ultrasound [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2024, 21(05): 517-521.
[2]	Jiayao Huang, Manxia Lin, Wenshuo Tian, Jingyi He, Jiaming Lai, Xiaoyan Xie, Haiyi Long. Influencing factors of feasibility and measurement values of pancreatic elastography in healthy adults [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(05): 524-529.
[3]	Houmei Han, Xuan Sheng, Dequan Liu, Yang Gao, Hong Yin. Value of ultrasound in prenatal diagnosis of fetal annular pancreas [J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2023, 20(01): 46-50.
[4]	Meng Li, La Jiang, Lei Dong, Qing Wu, Ben Li Jia. Clinical study of laparoscopic gastric sleeve resection in the treatment of obesity complicated with type 2 diabetes mellitus and fatty pancreas [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(05): 554-557.
[5]	Taiping Zhang, Yueze Liu. Key points and principles of laparoscopic pancreaticoduodenectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(03): 243-245.
[6]	Yinmo Yang, Yiran Chen, Xiaodong Tian. Continuously improve the standardization of laparoscopic pancreaticoduodenectomy [J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2024, 18(03): 237-242.
[7]	Branch of Organ Transplantation of Chinese Medical Association, Branch of Kidney Transplantation, China International Exchange and Promotive Association for Medical and Health Care. Clinical guideline for diagnosis and treatment of combined pancreas and kidney transplantation in China [J]. Chinese Journal of Transplantation(Electronic Edition), 2024, 18(03): 129-147.
[8]	Yi Zhao, Changtian Li, Wenbo Tang, Xueting Bai, Rong Liu. Clinical application of laparoscopic intraoperative ultrasound automatic main pancreatic ductidentificationmod [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(05): 290-294.
[9]	Kaixuan Fang, Yaqi Zhai, Guanjun Zhang, Shengxin Chen, Dexin Chen, Wenjing Liu, Yawen Liang, Mingyang Li. The safety and long-term efficacy of endoscopic retrograde cholangiopancreatography （ERCP） in the treatment of pancreas divi [J]. Chinese Journal of Laparoscopic Surgery(Electronic Edition), 2024, 17(05): 284-289.
[10]	Jinxin Huang, Jiajun Chen, Xuan Wang, Yan Qu, Xiwen Zhang, Fu Li. Application of ERCP in diagnosis and treatment of patients with pancreaticobiliary maljunction [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 699-704.
[11]	Liuping Luo, Mengmeng Wu, Xinlei Chen, Kecan Lin. Application value of total mesopancreas excision in radical resection of pancreatic head cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 651-656.
[12]	Yingbin Liu, Wei Chen. Problems and controversies in the concept of total mesopancreas excision [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(05): 615-619.
[13]	Yan Liao, Wei Cheng. Application of laparoscopy in pancreatic cancer [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2024, 13(03): 259-264.
[14]	Tianchi Yang, Wei Han, Feng Qiu, Jiahui Qi. Evaluation of pancreatic texture by intraoperative ultrasonic elastography [J]. Chinese Journal of Hepatic Surgery(Electronic Edition), 2023, 12(06): 646-650.
[15]	Bo Zhang, Yi Yao, Wengang Zhang, Ningli Chai, Enqiang Linghu. Peroral cholangioscopy treatment of biliary and pancreatic disease: How super minimally invasive surgery have changed ERCP [J]. Chinese Journal of Gastrointestinal Endoscopy(Electronic Edition), 2023, 10(04): 264-266.

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