Laparoscopic cephalic pancreaticoduodenectomy with laparoscopic vascular resection

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Gustavo Kohan
Juliana Di Menno Stavron
María E. Fratantoni
Héctor D. Vanzini
Santiago Rubio
Juan Peña
Javier Lendoire
Oscar Imventarza

Abstract

Background: Cephalic pancreaticoduodenectomy (CPD) with venous resection is indicated for the treatment of ductal adenocarcinoma and neuroendocrine tumors of the pancreas, either through laparoscopy or laparotomy.
Objective: The aim of this study was to describe the results of a series of patients undergoing CPD with venous vascular resection and compare morbidity and mortality between the laparoscopic approach and open surgery.
Material and methods: We conducted a retrospective, comparative and observational study of patients who underwent CPD with venous vascular resection between January 2022 and July 2023.
Criteria for laparoscopic surgery were age < 80 years, interface between tumor and vein of 180° of the circumference of the vessel wall or less on computed tomography, good performance status, and no previous neoadjuvant treatment.
Results: A total of 23 CPD procedures with venous vascular resection were performed: 11 by laparoscopy and 12 by laparotomy. The 11 laparoscopic procedures were lateral resections, and in the 12 patients approached by laparotomy, 5 were total portal vein resections and 7 were lateral resections. Portal vein clamping time and need for transfusion was similar in both groups. The pathological examination reported R0 resections in 78.2% and venous invasion in 40.9%. The complications associated with laparoscopy and laparotomy were pancreatic fistula in 4 and 3 patients, respectively, delayed gastric emptying in 1 and 4 patients, respectively, biliary fistula in 1 and 0 patients, respectively, aspiration pneumonia i 1 and 1 patients, respectively and surgical site infection in 0 and 1 patients, respectively. 

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How to Cite
Kohan, G., Di Menno Stavron, J., Fratantoni, M. E., Vanzini, H. D., Rubio, S., Peña, J., Lendoire, J., & Imventarza, O. (2024). Laparoscopic cephalic pancreaticoduodenectomy with laparoscopic vascular resection. Revista Argentina De Cirugía, 116(2), 106–114. Retrieved from https://revista.aac.org.ar/index.php/RevArgentCirug/article/view/655
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