full laparoscopie pancreaticoduodenumectomy: technic’s description
نویسندگان
چکیده
background the feasibility of safe full laparoscopic cephalic duodenopancreatectomy (cdp) has been demonstrated by several authors. objectives for its realization, we propose a 5 trocars approach. methods kocher maneuver is performed to reach the inferior vena cava, the infrarenal aorta, the rear plate of the uncinate process, and the superior mesenteric artery. lymphadenectomy in the region can be done in a comprehensive way; interaortico cave, around the hepatico-duodenal ligament, and the celiac trunk and its branches. after dissection of the portal vein (pv), the pancreas can be cut away from the tumor, and its right part is separated from the pv. the duodenal bulb and the first jejunal loop are cut using a linear stapler. after cholecystectomy, the bile duct is cut upstream of the cystic. results the reconstruction will include three anastomoses: termino-lateral posterior pancreatogastric by telescoping, end-to-side duodeno-jejunal and end-to-side hepatico-jejunal anastomoses. conclusions the cephalic duodenopancreatectomy (cdp) is entirely feasible laparoscopically. in obese patients, the cpd is more simple by laparoscopy. of course, performing this complex procedure requires a careful selection of patients and an experienced surgical team.
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عنوان ژورنال:
journal of minimally invasive surgical sciencesجلد ۵، شماره ۳، صفحات ۰-۰
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