Journal of the Pancreas Open Access

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Laparoscopic No-Touch Pancreaticoduodenectomy

Kopchak Volodymyr, Kopchak Kostiantyn, Duvalko Oleksandr, Khomyak Igor, Kvasivka Oleksandr, Andronik Serhii, Pererva Ludmila, Khanenko Vasiliy, Zubkov Oleksiy, Davidenko Nina, Romaniv Yaroslav

Objective One of the techniques, becoming more and more popular in open pancreatic surgery is no-touch PD. Laparoscopic access could bring some advantages to pancreatic resections. The aim of the present study was to determine possibility and safety of laparoscopic no-touch Pancreaticoduodenectomy in patients with periampullary tumors. Methods In the period 2013-2014 we performed 31 no-touch pancreaticoduodenectomy in the National institute of surgery and transplant ology NAMS of Ukraine. Of these patients 7 were selected for laparoscopic no-touch pancreaticoduodenectomy. Results Conversion rate was 42.8%. We analyzed the results of 4 successful laparoscopic pancreaticoduodenectomy. The mean duration of surgery was 443 ± 44 minutes (from 370 to 490 minutes). The mean blood loss was 650 ± 269 mL (from 300 to 1000 mL). In 3 patients (75.0%) postoperative complications were recorded in the form of pancreatic fistula grade B. Mortality was zero. After histological evaluation in all patients R0 resection was achieved. One patient died 3 months after the surgery from the reasons neither connected to the surgery, nor the disease. 1 patient has been alive for 11 months being diagnosed a metastatic disease on the 9-th month. 2 patients are alive without signs of recurrence (20 months and 14 months). Our preliminary results show, that no-touch technique could be done from laparoscopic access in a selected group of patients. Potential advantage is fast rehabilitation of patients with early start of adjuvant chemotherapy. That could be achieved in patients with uncomplicated postoperative period.