Laparoscopic Pancreatoduodenectomy: Results Evolution over 215 Procedures
https://doi.org/10.16931/1995-5464.2018-1-47-54
Abstract
Aim. To evaluate the outcomes of laparoscopic pancreatoduodenectomy (LPDE) along with experience accumulation.
Material and methods. Laparoscopic pancreatoduodenectomy was performed in 215 patients. There were hepatopancreatoduodenal malignant tumors in 187 (87%) cases and benign diseases in 28 (13%) patients. Pylorussparing LPDE was performed in 55 (26%) cases, gastropancreatoduodenectomy – in 160 (74%) patients. In 13 cases procedure was followed by segmental superior mesenteric vein/portal vein resection.
Results. Mean blood loss and time of surgery were 400 ml and 427 min, respectively. There was decrease of median operative time from 450 min in the first 50 operations to 320 min in the last 65 cases. Pancreatic fistula occurred in 32 (14.8%) patients. There was decrease of pancreatic fistula incidence from 21% in the first 100 patients to 9.6% in the last 115 cases. Delayed gastric emptying occurred in 7% of patients, overall morbidity was 35.5% and mortality – 6%. In 70 patients with pancreatic adenocarcinoma 3-year overall survival rate (OSR) was 35.5%, 5-year – 25.2%, median survival time – 22.5 months. In 11 patients with distal cholangiocarcinoma 3-year OSR was 57%, 5-year survival was absent. In 31 patients with ampullary carcinoma 3-year and 5-year OSR were the same – 67%.
Conclusion. Laparoscopic pancreatoduodenectomy is safe and effective procedure. There was a tendency to improved outcomes along with experience accumulation.
About the Authors
I. E. KhatkovRussian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Doct. of Med. Sci., Professor, Corresponding-member of RAS, Head of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Head of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
V. V. Tsvirkun
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
Doct. of Med. Sci., Professor, Chief Researcher of Loginov Moscow Clinical Research Center of Moscow Healthcare Department
R. E. Izrailov
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Doct. of Med. Sci., Professor, Head of the Innovative Surgery Department of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Professor of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
O. S. Vasnev
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Doct. of Med. Sci., Head of the Department of High-tech Surgery of Loginov Moscow Clinical Research Center of Moscow Healthcare Department
M. E. Baychorov
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
Phone: +7-926-453-15-10
Postgraduate Student of Loginov Moscow Clinical Research Center of Moscow Healthcare Department
P. S. Tyutyunnik
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Researcher of the Department of Innovative Surgery of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Assistant of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
A. A. Khisamov
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Surgeon of the Department of High-tech Surgery of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Assistant of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
A. V. Andrianov
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Researcher of the Department of Innovative Surgery of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Assistant of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
M. V. Mikhnevich
Russian Federation
86, shosse Enthuziastov, Moscow, 111123, Russian Federation
20/1, Delegatskaya str., Moscow, 127473, Russian Federation
Surgeon of the Department of High-tech Surgery of Loginov Moscow Clinical Research Center of Moscow Healthcare Department, Postgraduate Student of the Chair of Facultative Surgery №2 of Evdokimov Moscow State University of Medicine and Dentistry
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Review
For citations:
Khatkov I.E., Tsvirkun V.V., Izrailov R.E., Vasnev O.S., Baychorov M.E., Tyutyunnik P.S., Khisamov A.A., Andrianov A.V., Mikhnevich M.V. Laparoscopic Pancreatoduodenectomy: Results Evolution over 215 Procedures. Annaly khirurgicheskoy gepatologii = Annals of HPB Surgery. 2018;23(1):47-54. (In Russ.) https://doi.org/10.16931/1995-5464.2018-1-47-54