Laparoscopic pancreatic resection. From enucleation to pancreatoduodenectomy. 11-year experience

Detalhes bibliográficos
Autor(a) principal: Machado, Marcel Autran Cesar
Data de Publicação: 2013
Outros Autores: Surjan, Rodrigo Canada Trofo, Goldman, Suzan Menasce, Ardengh, Jose Celso, Makdissi, Fabio Ferrari
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.
id UFSP_bb81f661f04a5fb1e08aae73a9c43bbf
oai_identifier_str oai:repositorio.unifesp.br/:11600/7938
network_acronym_str UFSP
network_name_str Repositório Institucional da UNIFESP
repository_id_str 3465
spelling 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
_version_ 1814268297683664896