Total laparoscopic pancreaticoduodenectomy: a retrospective study of 27 cases treated in a single institution

Background: Since the first laparoscopic pancreaticoduodenectomy (LPD) was performed in 1994, the feasibility and safety of total laparoscopic pancreaticoduodenectomy (TLPD) have been confirmed by several single-institutional series. However, a standard approach is still lacking. Here, we present our initial experience of TLPD. Methods: We retrospectively reviewed 27 consecutive patients who had undergone TLPD performed by one operator between January 2013 and August 2016 at the Ningbo Medical Centre of Lihuili Hospital. Results: A total of 27 LPD were carried out, including two cases of portal vein (PV) resection and reconstruction. Conversion rate was in 4 patients (14.8%); mean operation time was 517 (range, 350-860) minutes; mean blood loss was 500 (range, 300-3,000) mL; mean hospital stay was 25 (range, 11-72) days. The overall postoperative morbidity was 44.4% (12 cases); mean number of collected lymph nodes was 12 (range, 2-59). R0 resection was obtained in 26 patients (96.3%). Conclusions: TLPD is safe and feasible. It is also possible to safely perform major venous resection and reconstruction during TLPD.