Laparoscopic No-Touch Pancreaticoduodenectomy

Objective One of the techniques, becoming more and more popular in open pancreatic surgery is no-touch PD. Laparoscopic access could bring some advantages to pancreatic resections. The aim of the present study was to determine possibility and safety of laparoscopic no-touch Pancreaticoduodenectomy in patients with periampullary tumors. Methods In the period 2013-2014 we performed 31 no-touch pancreaticoduodenectomy in the National institute of surgery and transplant ology NAMS of Ukraine. Of these patients 7 were selected for laparoscopic no-touch pancreaticoduodenectomy. Results Conversion rate was 42.8%. We analyzed the results of 4 successful laparoscopic pancreaticoduodenectomy. The mean duration of surgery was 443 ± 44 minutes (from 370 to 490 minutes). The mean blood loss was 650 ± 269 mL (from 300 to 1000 mL). In 3 patients (75.0%) postoperative complications were recorded in the form of pancreatic fistula grade B. Mortality was zero. After histological evaluation in all patients R0 resection was achieved. One patient died 3 months after the surgery from the reasons neither connected to the surgery, nor the disease. 1 patient has been alive for 11 months being diagnosed a metastatic disease on the 9-th month. 2 patients are alive without signs of recurrence (20 months and 14 months). Our preliminary results show, that no-touch technique could be done from laparoscopic access in a selected group of patients. Potential advantage is fast rehabilitation of patients with early start of adjuvant chemotherapy. That could be achieved in patients with uncomplicated postoperative period.

Author(s): Kopchak Volodymyr, Kopchak Kostiantyn, Duvalko Oleksandr, Khomyak Igor, Kvasivka Oleksandr, Andronik Serhii, Pererva Ludmila, Khanenko Vasiliy, Zubkov Oleksiy, Davidenko Nina, Romaniv Yaroslav

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