Video-assisted laparoscopic pancreaticoduodenectomy: A report of 5 cases / 中国微创外科杂志

ABSTRACT

Objective To explore the feasibility, difficulties and indications of video-assisted laparoscopic pancreaticoduodenectomy. Methods Clinical records of 5 cases of laparoscopic pancreaticoduodenectomy in this hospital from November 22, 2002 to April 28, 2005 were analyzed, with respect to preoperative diagnosis, surgical methods and procedures, intraoperative blood loss, operation time, difficulties encountered and countermeasures, and postoperative recovery. Related parameters included patient's temperature, drainage volume, blood routine, liver functions, amylopsin changes, postoperative complications, bowel movement recovery, and length of hospital stay. Results All the 5 cases of operation were successfully performed, with an operation time of 360~660 min (mean, 528 min) and an intraoperative blood loss of 150~2 000 ml (mean, 770 ml). Pathological examinations revealed 3 cases of well-differentiated papillary adenocarcinoma of the duodenum, 1 case of endocrine small-cell carcinoma of the head of pancreas, and 1 case of papillary adenomatoid hyperplasia of the duodenum with malignant changes accompanying intermediated-differentiated adenocarcinoma of upper and middle intrahepatic biliary duct. Postoperatively, a small amount of pancreatic leakage occurred in case number 1 and a digestive tract stress ulcer happened in case number 2, all of which were cured by symptomatic management. In case number 4, a recurrent pancreatitis with pulmonary infection was observed, and the patient died from stress ulcer hemorrhage on the 39th postoperative day. Except for the case number 4 in which the patient's highest temperature reached 39.5 ℃ after the recurrence of pancreatitis, the highest temperatures of the other 4 patients were all