Original Article
Experience in the laparoscopic duodenum preserving pancreatic head resection: a report of 4 patients
Botao Chen, Chuang Peng, Meifu Chen, Xianhai Mao, Lixue Zhou, Weizhi Gong, Yunfeng Li, Ou Li, Wei Cheng
Published 2019-10-28
Cite as Chin J Hepatobiliary Surg, 2019, 25(10): 755-758. DOI: 10.3760/cma.j.issn.1007-8118.2019.10.009
Abstract
ObjectiveTo summarized the experience in laparoscopic duodenum-preserving pancreatic head resection (LDPPHR).
MethodsThe clinical data of four patients who underwent LDPPHR from February 2017 to June 2018 in Hunan Provincial People’s Hospital were retrospectively analyzed. The Clinical characteristics, operation time, intraoperative blood loss, biliary fistula rate, pancreatic fistula rate and follow-up data were analyzed.
ResultsThe four patients included one patient with a solid pseudopapillary tumor and three patients with a serous cystadenoma. Two patients underwent duodenum-preserving total pancreatic head resection, and two patients underwent duodenum-preserving subtotal pancreatic head resection. The operation time of the four patients was (525.8±121.8) minutes, and the blood loss (250.0±191.5) ml. Biliary duct drainage was carried out in 2 patients: one patient developed biochemical bile leakage, while another had no postoperative complication. The two patients without biliary drainage developed grade B pancreatic leakage, delayed bile leakage, abdominal bleeding and infection. All the three patients who developed postoperative complications were treated conservatively and they recovered well.
ConclusionsLDPPHR was designed to better preserve the integrity and function of digestive tract. However, the perioperative complications were high. This operation should only be carried out in large pancreatic centers. Routine biliary drainage is recommended to surgeons with little experience in this operation.
Key words:
Laparoscopes; Pancreatic leakage; Bile leakage; Duodenum preserving pancreatic head resection
Contributor Information
Botao Chen
Translational Medicine Laboratory of Pancreas Disease, Hunan Provincial People’s Hospital (The First Affiliated Hospital of Hunan Normal University), Changsha 410005, China
Chuang Peng
Meifu Chen
Xianhai Mao
Lixue Zhou
Weizhi Gong
Yunfeng Li
Ou Li
Wei Cheng