Opportunities and challenges of parenchyma-preserving pancreatectomy in the era of laparoscopy and robot / 国际外科学杂志

ABSTRACT

The increasing incidence and early diagnosis of benign and low grade malignant tumor have presented new challenge to surgeons. Nowadays the safety of pancreatic surgery are warranted due to the progress of surgical techniques, resulting in the expansion of surgical indications. The long survival time post-operation of benign or low grade malignant tumors makes the preservation of endocrine and exocrine function of pancreas more and more important, and the parenchyma-preserving pancreatectomy has been increasing used at experienced medical center, including enucleation, central pancreatectomy and duodenum preserving pancreatic head resection. Compared with pancreaticoduodenectomy and distal pancreatectomy, significantly less patients suffered from endocrine and exocrine insufficiency after local resection of pancreas. More complications was observed after enucleation and duodenum preserving pancreatic head resection, mostly grade A pancreatic fistula, with low rate of mortality. Central pancreatectomy was associated with significantly more severe complications, compared with distal pancreatectomy. Laparoscopic or robotic local resection of pancreas are minimally invasive, and more suitable for the protection of main pancreatic duct with amplifying visions, and is more suitable for local resection of the pancreas than open surgery.