Email this article Laparoscopic interventions in the pancreas: an 11-year experience of a specialized center
- Authors: Khatkov I.E.1, Tsvirkun V.V.1, Izrailov R.E.1, Vasnev O.S.1, Tyutyunnik P.S.1, Mikhnevich M.V.1, Baychorov M.E.1, Andrianov A.V.1
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Affiliations:
- The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
- Issue: Vol 46, No 6 (2018)
- Pages: 640-647
- Section: ARTICLES
- URL: https://almclinmed.ru/jour/article/view/903
- DOI: https://doi.org/10.18786/2072-0505-2018-466-640-647
- ID: 903
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Full Text
Abstract
Introduction: Due to anatomical and functional specifics of the pancreas, its surgery emerged somewhat later than that of other areas of abdominal surgery, i.e. in the last 25 to 30 years of the last century. Minimally invasive laparoscopic interventions on the pancreas are still used insufficiently.
Aim: To evaluate an 11-year experience of various laparoscopic interventions in the pancreas accumulated by one surgical team.
Materials and methods: From November 2007 to May 2018, 371 patients (153 male and 218 female) underwent various laparoscopic pancreatic procedures for cancers of the biliopancreatoduodenal zone (n = 260), benign pancreatic tumors (n = 37), and chronic pancreatitis (n = 74). We performed 245 laparoscopic pancreaticoduodenal resections, 52 laparoscopic distal resections (LDR), 35 laparoscopic Frey procedures (FP), 18 laparoscopic total duodenopancreatectomies, 8 laparoscopic longitudinal pancreaticojejunostomies (LLPJ), 8 laparoscopic cystoenterostomies (LCE), 3 enucleations, and 2 Beger procedures (BP).
Results: Laparoscopic gastropancreatoduodenal resection was performed in 197 (80.4%) cases and pylorus preserving pancreatoduodenal resection in 48 (19.6%) cases. The duration of the procedures was 412 ± 101 minutes, with blood loss volume of 220 ± 152 ml, and postoperative hospital stay of 19 ± 9 days. LDR was done laparoscopically in 50 (96.2%) patients; its duration was 228 ± 74 minutes, blood loss 40 ± 50 ml, and postoperative hospital stay 8 ± 5 days. FP, LLPJ, BP, and LCE were performed laparoscopically in 53 (93%) cases. FP lasted for 436 ± 95, LLPJ for 406 ± 82, BP for 585 ± 134, and LCE for 327 ± 90 minutes. The respective volumes of blood loos were 227 ± 217 mL in FP, 150 ± 156 mL in LLPJ, 175 ± 106 mL in BP, and 60 ± 90 mL in LCE. The postoperative hospital stay lasted for 8 ± 4 days after FP, 9 ± 7 days after LLPJ, 4.5 ± 0.7 days after BP, and 10 ± 9 days after LCE.
Conclusion: Laparoscopic surgery of the pancreas is associated with minimal blood loss, absence of wound infection, and more rapid patient activation and rehabilitation. Compliance with the necessary requirements to implementation of laparoscopic technologies in high-volume centers should improve surgical results.
About the authors
I. E. Khatkov
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Igor E. Khatkov – Member-Correspondent of Russian Academy of Sciences, MD, PhD, Professor, Director.
86 Shosse Entuziastov, Moscow, 111123
РоссияV. V. Tsvirkun
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Victor V. Tsvirkun – MD, PhD, Professor, Chief Research Fellow.
86 Shosse Entuziastov, Moscow, 111123
РоссияR. E. Izrailov
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Roman E. Izrailov – MD, PhD, Head of the Department of Innovative Surgery.
86 Shosse Entuziastov, Moscow, 111123
РоссияO. S. Vasnev
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Oleg S. Vasnev – MD, PhD, Head of the Department of High-Tech Surgery and Endoscopic Surgery.
86 Shosse Entuziastov, Moscow, 111123
РоссияP. S. Tyutyunnik
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Pavel S. Tyutyunnik – MD, Research Fellow, Department of High-Tech Surgery and Endoscopic Surgery.
86 Shosse Entuziastov, Moscow, 111123
РоссияM. V. Mikhnevich
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Mikhail V. Mikhnevich – MD, Research Fellow, Department of High-Tech Surgery and Endoscopic Surgery.
86 Shosse Entuziastov, Moscow, 111123
РоссияM. E. Baychorov
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Email: fake@neicon.ru
Magomed E. Baychorov – MD, Research Fellow, Department of High-Tech Surgery and Endoscopic Surgery.
86 Shosse Entuziastov, Moscow, 111123
РоссияA. V. Andrianov
The Loginov Moscow Clinical Scientific Center, Moscow Healthcare Department
Author for correspondence.
Email: andnov2@gmail.com
Aleksey V. Andrianov – MD, Research Fellow, Department of High-Tech Surgery and Endoscopic Surgery.
9/7–209 Teply Stan ul., Moscow, 117465, tel.: +7 (903) 140 16 82
РоссияReferences
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