Total laparoscopic pancreatico-duodenectomy
Epublication WebSurg.com, Jun 2016;16(06). URL: http://websurg.com/doi/lt03encury002
Laparoscopic pancreatectomy has recently emerged as one of the most advanced applications of surgery and total laparoscopic pancreaticoduodenectomy (TLPD) has proven to be among one of the most advanced laparoscopic procedures. The evolution in laparoscopic technology and instrumentation within the past decade has let laparoscopic pancreaticoduodenectomy gain wider acceptance. Also known as the Whipple procedure, it was first performed laparoscopically in 1994. It consists of a biliary-enteric and of a gastro-enteric anastomosis. It is a two-step procedure: dissection is performed first, reconstruction follows. The laparoscopic approach requires comparatively longer operative times and necessitates advanced laparoscopic skills and hybrid approaches. Bleeding is a severe complication. People die of gastroduodenal and hepatic artery bleeding. The retroperitoneal part of the pancreas is involved in 51 to 93% of cases. Bleeding is a major complication during this procedure, which can be controlled by compressing, inserting another port, clamping, and stitching.