Feasibility analysis and safety of laparoscopic pylorus-preserving pancreaticoduodenectomy / 局解手术学杂志

ABSTRACT

Objective To investigate the safety and feasibility of laparoscopic pylorus-preserving pancreaticoduodenectomy.MethodsThe data of 59 patients with laparoscopic pancreaticoduodenectomy in Shangjin hospital of West China hospital of Sichuan University from January 2014 to December 2015 were analyzed retrospectively.The general data,operative time,estimated blood loss,conversion rate,time to liquid diet,postoperative hospital stay and complications were analyzed.Results The laparoscopic pylorus-preserving pancreaticoduodenectomy were successfully performed in 56 cases,the successful rate was 94.9%,the other 3 patients were converted to laparotomy for superior mesenteric vein/portal vein involvement.The operative time was 255~510 minutes,with mean operative time (384±145) minutes,the intraoperatve blood soss was 50~800 mL,with mean estimated blood loss (148±28)mL,the time to liquid diet was 1.0~4.0 days,with average time (3.2±1.1)days,the postoperative hospital stay was 5.0~53.0 days,with average time (10.3±2.6)days.After surgery,16 cases suffered from complication,the rate was 27.1%.The most common complication was pancreatic fistula which occurred in 13 cases including 12 cases of grade A and 1 case of grade pancreatic fistula.No grade C pancreatic fistula occurred in this series.Six patients suffered from delayed gastric emptying.One patient suffered from bile leakage.Conclusion Laparoscopic pylorus-preserving pancreaticoduodenectomy was safe and feasible.Pylorus-preserving does not increase the incidence of delayed gastric emptying.