Laparoscopic reconstruction technique of cephalic duodenopancreatectomy

Abstract

Background: pancreatoduodenectomy is the procedure indicated for the treatment of ampullary and periampullary tumors. The total laparoscopic approach for pancreatoduodenectomy is technically difficult to perform requiring skill and great experience of the surgical team. The technical difficulty of the pancreatojejunostomy is perhaps the limiting factor to perform the pancreatoduodenectomy totally laparoscopic.
Objective: to describe the technique of the laparoscopic reconstruction using the pancreatojejunostomy according to the Blumgart modified technique.
Material and methods: patients operated entirely by totally laparoscopic approach were analyzed. These patients were reconstructed performing a pancreatojejunostomy with the Blumgart modified technique.
Results: in patients with totally laparoscopic approach, pancreas texture was intermediatein 3 patients and 2 had soft texture. The average operating time was 384 minutes. The average hospital stay was 12 days. Two patients developed pancreatic fistula type A. One patient had delayed gastric emptying which resolved spontaneously.
Conclusion: total laparoscopic reconstruction is feasible and reproducible with the same technique used by laparotomy.