Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience
Autor(a) principal: | |
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Data de Publicação: | 2013 |
Outros Autores: | , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNIFESP |
Texto Completo: | http://dx.doi.org/10.1590/S0004-28032013000200038 http://repositorio.unifesp.br/handle/11600/7938 |
Resumo: | Context Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Results Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons. |
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Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experiencePancreatectomia laparoscopica. Da enucleacao a duodenopancreatectomia. 11 anos de experienciaPancreatectomyPancreaticoduodenectomyLaparoscopyPancreatectomiaPancreaticoduodenectomiaLaparoscopiaContext Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Results Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons.Contexto Nossa experiência com ressecção pancreática laparoscópica começou em 2001. No início, a laparoscopia esteve reservada para casos selecionados. Com o aumento da experiência, procedimentos mais complexos, como pancreatectomia central e pancreato duodenectomia, foram realizadas por laparoscopia. Objetivos O objetivo deste trabalho foi rever a experiência de 11 anos com ressecção pancreática laparoscópica. Métodos Foram analisados todos os pacientes submetidos à ressecção pancreática laparoscópica entre 2001 e 2012 e incluídos dados pré-operatórios como idade, sexo e indicação cirúrgica, bem como variáveis intra-operatórias como o tempo operatório, o sangramento e transfusão. O diagnóstico final, o tamanho e a margem foram determinados a partir dos laudos anatomopatológicos. Resultados Desde 2001, 96 pacientes foram submetidos à pancreatectomia laparoscópica. A média de idade foi de 55 anos. Foram 60 homens e 36 mulheres. Oitenta e oito (91,6%) operações foram realizadas por laparoscopia e quatro (4,2%) necessitaram de auxílio da mão e uma robótica. Três pacientes foram convertidos. Quatro necessitaram de transfusão de sangue. O tempo operatório variou de acordo com tipo de operação. A mortalidade foi nula, mas a morbidade foi alta, principalmente devido à fístulas pancreáticas (28,1%). Sessenta e um pacientes foram submetidos à pancreatectomia distal, 18 à enucleação do pâncreas, 7 à duodenopancreatectomia com preservação de piloro, 5 à ressecção do processo uncinado, 3 centrais e duas pancreatectomias totais. Conclusão Ressecção laparoscópica do pâncreas é uma realidade. Técnicas que preservam o parênquima, como enucleação, ressecção do processo uncinado e pancreatectomia central, devem ser usadas para evitar insuficiência exócrina e/ou endócrina. Duodenopancreatectomia laparoscópica é operação segura, mas deve ser realizada em centros especializados e por cirurgiões laparoscópicos adequadamente treinados.Hospital Sirio LibanesUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de Diagnostico por Imagemniversidade de São Paulo Faculdade de Medicina de Ribeirao Preto Departamento de Cirurgia e AnatomiaUNIFESP, EPM, Depto. de Diagnostico por ImagemSciELOInstituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBEDHospital Sirio LibanesUniversidade Federal de São Paulo (UNIFESP)Universidade de São Paulo Faculdade de Medicina de Ribeirao Preto Departamento de Cirurgia e AnatomiaMachado, Marcel Autran CesarSurjan, Rodrigo Canada TrofoGoldman, Suzan MenasceArdengh, Jose CelsoMakdissi, Fabio Ferrari2015-06-14T13:45:36Z2015-06-14T13:45:36Z2013-09-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersion214-218application/pdfhttp://dx.doi.org/10.1590/S0004-28032013000200038Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 50, n. 3, p. 214-218, 2013.10.1590/S0004-28032013000200038S0004-28032013000300214.pdf0004-2803S0004-28032013000300214http://repositorio.unifesp.br/handle/11600/7938engArquivos de Gastroenterologiainfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da UNIFESPinstname:Universidade Federal de São Paulo (UNIFESP)instacron:UNIFESP2024-07-29T11:23:00Zoai:repositorio.unifesp.br/:11600/7938Repositório InstitucionalPUBhttp://www.repositorio.unifesp.br/oai/requestbiblioteca.csp@unifesp.bropendoar:34652024-07-29T11:23Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP)false |
dc.title.none.fl_str_mv |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience Pancreatectomia laparoscopica. Da enucleacao a duodenopancreatectomia. 11 anos de experiencia |
title |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
spellingShingle |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience Machado, Marcel Autran Cesar Pancreatectomy Pancreaticoduodenectomy Laparoscopy Pancreatectomia Pancreaticoduodenectomia Laparoscopia |
title_short |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
title_full |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
title_fullStr |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
title_full_unstemmed |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
title_sort |
Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience |
author |
Machado, Marcel Autran Cesar |
author_facet |
Machado, Marcel Autran Cesar Surjan, Rodrigo Canada Trofo Goldman, Suzan Menasce Ardengh, Jose Celso Makdissi, Fabio Ferrari |
author_role |
author |
author2 |
Surjan, Rodrigo Canada Trofo Goldman, Suzan Menasce Ardengh, Jose Celso Makdissi, Fabio Ferrari |
author2_role |
author author author author |
dc.contributor.none.fl_str_mv |
Hospital Sirio Libanes Universidade Federal de São Paulo (UNIFESP) Universidade de São Paulo Faculdade de Medicina de Ribeirao Preto Departamento de Cirurgia e Anatomia |
dc.contributor.author.fl_str_mv |
Machado, Marcel Autran Cesar Surjan, Rodrigo Canada Trofo Goldman, Suzan Menasce Ardengh, Jose Celso Makdissi, Fabio Ferrari |
dc.subject.por.fl_str_mv |
Pancreatectomy Pancreaticoduodenectomy Laparoscopy Pancreatectomia Pancreaticoduodenectomia Laparoscopia |
topic |
Pancreatectomy Pancreaticoduodenectomy Laparoscopy Pancreatectomia Pancreaticoduodenectomia Laparoscopia |
description |
Context Our experience with laparoscopic pancreatic resection began in 2001. During initial experience, laparoscopy was reserved for selected cases. With increasing experience more complex laparoscopic procedures such as central pancreatectomy and pancreatoduodenectomies were performed. Objectives The aim of this paper is to review our personal experience with laparoscopic pancreatic resection over 11-year period. Methods All patients who underwent laparoscopic pancreatic resection from 2001 through 2012 were reviewed. Preoperative data included age, gender, and indication for surgery. Intraoperative variables included operative time, bleeding, blood transfusion. Diagnosis, tumor size, margin status were determined from final pathology reports. Results Since 2001, 96 patients underwent laparoscopic pancreatectomy. Median age was 55 years old. 60 patients were female and 36 male. Of these, 88 (91.6%) were performed totally laparoscopic; 4 (4.2%) needed hand-assistance, 1 robotic assistance. Three patients were converted. Four patients needed blood transfusion. Operative time varied according type of operation. Mortality was nil but morbidity was high, mainly due to pancreatic fistula (28.1%). Sixty-one patients underwent distal pancreatectomy, 18 underwent pancreatic enucleation, 7 pylorus-preserving pancreatoduodenectomies, 5 uncinate process resection, 3 central and 2 total pancreatectomies. Conclusions Laparoscopic resection of the pancreas is a reality. Pancreas sparing techniques, such as enucleation, resection of uncinate process and central pancreatectomy, should be used to avoid exocrine and/or endocrine insufficiency that could be detrimental to the patient's quality of life. Laparoscopic pancreatoduodenectomy is a safe operation but should be performed in specialized centers by highly skilled laparoscopic surgeons. |
publishDate |
2013 |
dc.date.none.fl_str_mv |
2013-09-01 2015-06-14T13:45:36Z 2015-06-14T13:45:36Z |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1590/S0004-28032013000200038 Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 50, n. 3, p. 214-218, 2013. 10.1590/S0004-28032013000200038 S0004-28032013000300214.pdf 0004-2803 S0004-28032013000300214 http://repositorio.unifesp.br/handle/11600/7938 |
url |
http://dx.doi.org/10.1590/S0004-28032013000200038 http://repositorio.unifesp.br/handle/11600/7938 |
identifier_str_mv |
Arquivos de Gastroenterologia. Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED, v. 50, n. 3, p. 214-218, 2013. 10.1590/S0004-28032013000200038 S0004-28032013000300214.pdf 0004-2803 S0004-28032013000300214 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Arquivos de Gastroenterologia |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
214-218 application/pdf |
dc.publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED |
publisher.none.fl_str_mv |
Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia - IBEPEGE Colégio Brasileiro de Cirurgia Digestiva - CBCD Sociedade Brasileira de Motilidade Digestiva - SBMD Federação Brasileira de Gastroenterologia - FBGSociedade Brasileira de Hepatologia - SBHSociedade Brasileira de Endoscopia Digestiva - SOBED |
dc.source.none.fl_str_mv |
reponame:Repositório Institucional da UNIFESP instname:Universidade Federal de São Paulo (UNIFESP) instacron:UNIFESP |
instname_str |
Universidade Federal de São Paulo (UNIFESP) |
instacron_str |
UNIFESP |
institution |
UNIFESP |
reponame_str |
Repositório Institucional da UNIFESP |
collection |
Repositório Institucional da UNIFESP |
repository.name.fl_str_mv |
Repositório Institucional da UNIFESP - Universidade Federal de São Paulo (UNIFESP) |
repository.mail.fl_str_mv |
biblioteca.csp@unifesp.br |
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1814268297683664896 |