Minimally Invasive Pancreatic Surgery: What the Future Holds for This Field?

  • P. Senthilnathan
  • S. Srivatsan Gurumurthy
  • C. Palanivelu
Part of the GI Surgery Annual book series (GISA, volume 24)


Minimally invasive surgery, a widely adopted tool for most domains of gastrointestinal surgery, has been relatively slow to evolve in the field of pancreatic surgery. The reasons include proximity to the great vessels, retroperitoneal location, need for advanced intracorporeal suturing skills and increased risk of complications associated with these procedures. With enormous development in surgical technology coupled with improved anatomical knowledge and refined skills, minimally invasive pancreatic surgery has grown out of its infancy and is an established specialty in hepato-pancreato-biliary surgery today. As a result, the initial scepticism and reluctance associated with minimally invasive pancreatic resections has decreased and many surgeons are attempting to enter this difficult terrain. Recent publications highlight potential advantages of minimally invasive pancreatic resection (MIPR) over open pancreatic resection (OPR). These include reduced pain, decreased blood loss and need for transfusion, an earlier return of bowel function, decreased wound infection rates and shorter intensive care unit and overall hospital stays [1, 2]. Though the number of minimally invasive pancreatic resections performed for benign and malignant diseases of the pancreas has increased in recent years, cost considerations and financial implications of these new approaches need to be well defined [3–5]. Clear guidelines and standardization of surgical technique are paramount for the safe and steady expansion of this novel surgical approach [6].


  1. 1.
    Song KB, Kim SC, Hwang DW, Lee JH, Lee DJ, Lee JW, et al. Matched case–control analysis comparing laparoscopic and open pylorus-preserving pancreaticoduodenectomy in patients with periampullary tumors. Ann Surg. 2015;262:146–55.CrossRefGoogle Scholar
  2. 2.
    Stauffer JA, Coppola A, Villacreses D, Mody K, Johnson E, Li Z, et al. Laparoscopic versus open pancreaticoduodenectomy for pancreatic adenocarcinoma: long-term results at a single institution. Surg Endosc. 2017;31:2233–41.CrossRefGoogle Scholar
  3. 3.
    Boggi U, Amorese G, Vistoli F, Caniglia F, De Lio N, Perrone V, et al. Laparoscopic pancreaticoduodenectomy: a systematic literature review. Surg Endosc. 2015;29:9–23.CrossRefGoogle Scholar
  4. 4.
    Liao CH, Wu YT, Liu YY, Wang SY, Kang SC, Yeh CN, et al. Systemic review of the feasibility and advantage of minimally invasive pancreaticoduodenectomy. World J Surg. 2016;40:1218–25.CrossRefGoogle Scholar
  5. 5.
    Delitto D, Luckhurst CM, Black BS, Beck JL, George TJ Jr, Sarosi GA, et al. Oncologic and perioperative outcomes following selective application of laparoscopic pancreaticoduodenectomy for periampullary malignancies. J Gastrointest Surg. 2016;20:1343–9.CrossRefGoogle Scholar
  6. 6.
    Vollmer CM, Asbun HJ, Barkun J, Besselink MG, Boggi U, Conlon KC, et al. Proceedings of the first international state-of-the-art conference on minimally-invasive pancreatic resection (MIPR). HPB (Oxford). 2017;19:171–7.CrossRefGoogle Scholar
  7. 7.
    Soliman HO, Gad ZS, Mahmoud AM, Farahat AM, Abdelrazek NM, Gareer WY. Laparoscopy with laparoscopic ultrasound for pretreatment staging of hepatic focal lesions: a prospective study. J Egypt Natl Canc Inst. 2011;23:141–5.CrossRefGoogle Scholar
  8. 8.
    Cuschieri A. Laparoscopic surgery of the pancreas. J R Coll Surg Edinb. 1994;39:178–84.PubMedGoogle Scholar
  9. 9.
    Gagner M, Pomp A, Herrera MF. Early experience with laparoscopic resections of islet cell tumors. Surgery. 1996;120:1051–4.CrossRefGoogle Scholar
  10. 10.
    Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc. 1994;8:408–10.CrossRefGoogle Scholar
  11. 11.
    Palanivelu C, Jani K, Senthilnathan P, Parthasarathi R, Rajapandian S, Madhankumar MV. Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg. 2007;205:222–30.CrossRefGoogle Scholar
  12. 12.
    Pugliese R, Scandroglio I, Sansonna F, Maggioni D, Costanzi A, Citterio D, et al. Laparoscopic pancreaticoduodenectomy: a retrospective review of 19 cases. Surg Laparosc Endosc Percutan Tech. 2008;18:13–8.CrossRefGoogle Scholar
  13. 13.
    Gumbs AA, Gayet B. The laparoscopic duodenopancreatectomy: the posterior approach. Surg Endosc. 2008;22:539–40.CrossRefGoogle Scholar
  14. 14.
    Palanivelu C, Rajan PS, Rangarajan M, Vaithiswaran V, Senthilnathan P, Parthasarathi R, et al. Evolution in techniques of laparoscopic pancreaticoduodenectomy: a decade long experience from a tertiary center. J Hepatobiliary Pancreat Surg. 2009;16:731–40.CrossRefGoogle Scholar
  15. 15.
    Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience. Arch Surg. 2010;145:19–23.CrossRefGoogle Scholar
  16. 16.
    Kooby DA, Chu CK. Laparoscopic management of pancreatic malignancies. Surg Clin North Am. 2010;90:427–46.CrossRefGoogle Scholar
  17. 17.
    Zureikat AH, Breaux JA, Steel JL, Hughes SJ. Can laparoscopic pancreaticoduodenectomy be safely implemented? J Gastrointest Surg. 2011;15(7):1151.CrossRefGoogle Scholar
  18. 18.
    Asbun HJ, Stauffer JA. Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the accordion severity grading system. J Am Coll Surg. 2012;215:810–9.CrossRefGoogle Scholar
  19. 19.
    Chalikonda S, Aguilar-Saavedra JR, Walsh RM. Laparoscopic robotic-assisted pancreatico- duodenectomy: a case-matched comparison with open resection. Surg Endosc. 2012;26:2397–402.CrossRefGoogle Scholar
  20. 20.
    Kim SC, Song KB, Jung YS, Kim YH, Park DH, Lee SS, et al. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc. 2013;27:95–103.CrossRefGoogle Scholar
  21. 21.
    Pamoukian VN, Gagner M. Laparoscopic necrosectomy for acute necrotizing pancreatitis. J Hepato-Biliary-Pancreat Surg. 2001;8(3):221.CrossRefGoogle Scholar
  22. 22.
    Babu BI, Siriwardena AK. Current status of minimally invasive necrosectomy for post-inflammatory pancreatic necrosis. HPB (Oxford). 2009;11:96–102.CrossRefGoogle Scholar
  23. 23.
    Kurian MS, Gagner M. Laparoscopic side-to-side pancreaticojejunostomy (Partington–Rochelle) for chronic pancreatitis. J Hepato-Biliary-Pancreat Surg. 1999;6:382–6.CrossRefGoogle Scholar
  24. 24.
    Kim EY, Hong TH. Laparoscopic longitudinal pancreaticojejunostomy using barbed sutures: an efficient and secure solution for pancreatic duct obstructions in patients with chronic pancreatitis. J Gastrointest Surg. 2016;20:861–6.CrossRefGoogle Scholar
  25. 25.
    Khaled YS, Ammori MB, Ammori BJ. Laparoscopic lateral pancreaticojejunostomy for chronic pancreatitis: a case report and review of the literature. Surg Laparosc Endosc Percutan Tech. 2011;21:e36–40.CrossRefGoogle Scholar
  26. 26.
    Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, et al. A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg. 2010;210:779–85–86–7.CrossRefGoogle Scholar
  27. 27.
    Sui CJ, Li B, Yang JM, Wang SJ, Zhou YM. Laparoscopic versus open distal pancreatectomy: a meta-analysis. Asian J Surg. 2012;35:1–8.CrossRefGoogle Scholar
  28. 28.
    Sahakyan MA, Kazaryan AM, Rawashdeh M, Fuks D, Shmavonyan M, Haugvik SP, et al. Laparoscopic distal pancreatectomy for pancreatic ductal adenocarcinoma: results of a multicenter cohort study on 196 patients. Surg Endosc. 2016;30:3409–18.CrossRefGoogle Scholar
  29. 29.
    Riviere D, Gurusamy KS, Kooby DA, Vollmer CM, Besselink MG, Davidson BR, et al. Laparoscopic versus open distal pancreatectomy for pancreatic cancer. Cochrane Database Syst Rev. 2016;4:CD011391.PubMedGoogle Scholar
  30. 30.
    Teh SH, Tseng D, Sheppard BC. Laparoscopic and open distal pancreatic resection for benign pancreatic disease. J Gastrointest Surg. 2007;11:1120–5.CrossRefGoogle Scholar
  31. 31.
    Matsumoto T, Shibata K, Ohta M, Iwaki K, Uchida H, Yada K, et al. Laparoscopic distal pancreatectomy and open distal pancreatectomy: a nonrandomized comparative study. Surg Laparosc Endosc Percutan Tech. 2008;18:340–3.CrossRefGoogle Scholar
  32. 32.
    Bruzoni M, Sasson AR. Open and laparoscopic spleen-preserving, splenic vessel-preserving distal pancreatectomy: indications and outcomes. J Gastrointest Surg. 2008;12:1202–6.CrossRefGoogle Scholar
  33. 33.
    Eom BW, Jang JY, Lee SE, Han HS, Yoon YS, Kim SW. Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc. 2008;22:1334–8.CrossRefGoogle Scholar
  34. 34.
    Casadei R, Ricci C, D’Ambra M, Marrano N, Alagna V, Rega D, et al. Laparoscopic versus open distal pancreatectomy in pancreatic tumours: a case-control study. Updat Surg. 2010;62:171–4.CrossRefGoogle Scholar
  35. 35.
    Asbun HJ, Stauffer JA. Laparoscopic approach to distal and subtotal pancreatectomy: a clockwise technique. Surg Endosc. 2011;25:2643–9.CrossRefGoogle Scholar
  36. 36.
    Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc. 2007;21:373–7.CrossRefGoogle Scholar
  37. 37.
    Ammori BJ, Ayiomamitis GD. Laparoscopic pancreaticoduodenectomy and distal pancreatectomy: a UK experience and a systematic review of the literature. Surg Endosc. 2011;25:2084–99.CrossRefGoogle Scholar
  38. 38.
    Kudsi OY, Gagner M, Jones DB. Laparoscopic distal pancreatectomy. Surg Oncol Clin N Am. 2013;22:59–73, vi.CrossRefGoogle Scholar
  39. 39.
    Abu Hilal M, Takhar AS. Laparoscopic left pancreatectomy: current concepts. Pancreatology. 2013;13:443–8.CrossRefGoogle Scholar
  40. 40.
    Abu Hilal M, Richardson JR, de Rooij T, Dimovska E, Al-Saati H, Besselink MG. Laparoscopic radical ‘no-touch’ left pancreatosplenectomy for pancreatic ductal adenocarcinoma: technique and results. Surg Endosc. 2016;30:3830–8.CrossRefGoogle Scholar
  41. 41.
    Diener MK, Knaebel HP, Witte ST, Rossion I, Kieser M, Buchler MW, et al. DISPACT trial: a randomized controlled trial to compare two different surgical techniques of distal pancreatectomy–study rationale and design. Clin Trials. 2008;5:534–45.CrossRefGoogle Scholar
  42. 42.
    Abu Hilal M, Hamdan M, Di Fabio F, Pearce NW, Johnson CD. Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study. Surg Endosc. 2012;26:1670–4.CrossRefGoogle Scholar
  43. 43.
    Braga M, Pecorelli N, Ferrari D, Balzano G, Zuliani W, Castoldi R. Results of 100 consecutive laparoscopic distal pancreatectomies: postoperative outcome, cost-benefit analysis, and quality of life assessment. Surg Endosc. 2015;29:1871–8.CrossRefGoogle Scholar
  44. 44.
    de Rooij T, van Hilst J, Vogel JA, van Santvoort HC, de Boer MT, Boerma D, et al. Minimally invasive versus open distal pancreatectomy (LEOPARD): study protocol for a randomized controlled trial. Trials. 2017;18:166.CrossRefGoogle Scholar
  45. 45.
    Higuchi A, Yasugi H, Yokota T, Tobe T, Mizumoto R. Changes of pancreatic exocrine function after major resection of the pancreas in dogs. Gastroenterol Jpn. 1979;14:316–26.CrossRefGoogle Scholar
  46. 46.
    Al-Kurd A, Chapchay K, Grozinsky-Glasberg S, Mazeh H. Laparoscopic resection of pancreatic neuroendocrine tumors. World J Gastroenterol. 2014;20:4908–16.CrossRefGoogle Scholar
  47. 47.
    Zhang RC, Zhou YC, Mou YP, Huang CJ, Jin WW, Yan JF, et al. Laparoscopic versus open enucleation for pancreatic neoplasms: clinical outcomes and pancreatic function analysis. Surg Endosc. 2016;30:2657–65.CrossRefGoogle Scholar
  48. 48.
    Iacono C, Ruzzenente A, Bortolasi L, Guglielmi A. Central pancreatectomy: the Dagradi Serio Iacono operation. Evolution of a surgical technique from the pioneers to the robotic approach. World J Gastroenterol. 2014;20:15674–81.CrossRefGoogle Scholar
  49. 49.
    Machado MA, Surjan RC, Epstein MG, Makdissi FF. Laparoscopic central pancreatectomy: a review of 51 cases. Surg Laparosc Endosc Percutan Tech. 2013;23:486–90.CrossRefGoogle Scholar
  50. 50.
    Senthilnathan P, Gul SI, Gurumurthy SS, Palanivelu PR, Parthasarathi R, Palanisamy NV, et al. Laparoscopic central pancreatectomy: our technique and long-term results in 14 patients. J Minim Access Surg. 2015;11:167–71.CrossRefGoogle Scholar
  51. 51.
    Rossidis G, Hughes SJ. Minimally invasive treatment of pancreatic disease. Curr Gastroenterol Rep. 2012;14:125–30.CrossRefGoogle Scholar
  52. 52.
    Cho A, Yamamoto H, Nagata M, Takiguchi N, Shimada H, Kainuma O, et al. Comparison of laparoscopy-assisted and open pylorus-preserving pancreaticoduodenectomy for periampullary disease. Am J Surg. 2009;198:445–9.CrossRefGoogle Scholar
  53. 53.
    Gumbs AA, Grès P, Madureira FA, Gayet B. Laparoscopic vs. open resection of noninvasive intraductal pancreatic mucinous neoplasms. J Gastrointest Surg. 2008;12:707–12.CrossRefGoogle Scholar
  54. 54.
    Lu B, Huang Y, Cai X, Huang F, Li J, Lu W, et al. A novel method for reconstruction in laparoscopic pancreaticoduodenectomy: an experience of 13 cases. Front Med China. 2007;1:369–72.CrossRefGoogle Scholar
  55. 55.
    Senthilnathan P, Chinnusamy P, Ramanujam A, Sivakumar SG, Natesan AV, Chandramaliteeswaran C, et al. Comparison of pathological radicality between open and laparoscopic pancreaticoduodenectomy in a tertiary Centre. Indian J Surg Oncol. 2015;6:20–5.CrossRefGoogle Scholar
  56. 56.
    Senthilnathan P, Srivatsan Gurumurthy S, Gul SI, Sabnis S, Natesan AV, Palanisamy NV, et al. Long-term results of laparoscopic pancreaticoduodenectomy for pancreatic and periampullary cancer-experience of 130 cases from a tertiary-care center in South India. J Laparoendosc Adv Surg Tech A. 2015;25:295–300.CrossRefGoogle Scholar
  57. 57.
    Palanisamy S, Sabnis SC, Patel ND, Gurumurthy S, Natesan AV, Palanisamy N, et al. Prospective randomized controlled trial comparing laparoscopic versus open pancreaticoduodenectomy for malignant periampullary and pancreatic head lesions. HPB. 2015;18:e3–4.CrossRefGoogle Scholar
  58. 58.
    Correa-Gallego C, Dinkelspiel HE, Sulimanoff I, Fisher S, Viñuela EF, Kingham TP, et al. Minimally-invasive vs open pancreaticoduodenectomy: systematic review and meta-analysis. J Am Coll Surg. 2014;218:129–39.CrossRefGoogle Scholar
  59. 59.
    Sanjay P, Takaori K, Govil S, Shrikhande SV, Windsor JA. ‘Artery-first’ approaches to pancreatoduodenectomy. Br J Surg. 2012;99:1027–35.CrossRefGoogle Scholar
  60. 60.
    Nagakawa Y, Hosokawa Y, Sahara Y, Takishita C, Nakajima T, Hijikata Y, et al. A novel ‘artery first’ approach allowing safe resection in laparoscopic pancreaticoduodenectomy: the uncinate process first approach. Hepato-Gastroenterology. 2015;62:1037–40.PubMedGoogle Scholar
  61. 61.
    Pittau G, Sànchez-Cabùs S, Laurenzi A, Gelli M, Cunha AS. Laparoscopic pancreaticoduodenectomy: right posterior superior mesenteric artery ‘first’ approach. Ann Surg Oncol. 2015;22(Suppl 3):S345–8.CrossRefGoogle Scholar
  62. 62.
    Negoi I, Hostiuc S, Runcanu A, Negoi RI, Beuran M. Superior mesenteric artery first approach versus standard pancreaticoduodenectomy: a systematic review and meta-analysis. Hepatobiliary Pancreat Dis Int. 2017;16:127–38.CrossRefGoogle Scholar
  63. 63.
    Croome KP, Farnell MB, Que FG, Reid-Lombardo KM, Truty MJ, Nagorney DM, et al. Pancreaticoduodenectomy with major vascular resection: a comparison of laparoscopic versus open approaches. J Gastrointest Surg. 2015;19:189–94.CrossRefGoogle Scholar
  64. 64.
    Palanisamy S, Deuri B, Naidu SB, Vaiyapurigoundar Palanisamy N, Natesan AV, Palanivelu PR, et al. Major venous resection and reconstruction using a minimally invasive approach during laparoscopic pancreaticoduodenectomy: one step forward. Asian J Endosc Surg. 2015;8:468–72.CrossRefGoogle Scholar
  65. 65.
    Rasch S, Phillip V, Reichel S, Rau B, Zapf C, Rosendahl J, et al. Open surgical versus minimal invasive necrosectomy of the pancreas––a retrospective multicenter analysis of the German pancreatitis study group. PLoS One. 2016;11:e0163651.CrossRefGoogle Scholar
  66. 66.
    Besselink MG, van Santvoort HC, Nieuwenhuijs VB, Boermeester MA, Bollen TL, Buskens E, et al. Minimally invasive ‘step-up approach’ versus maximal necrosectomy in patients with acute necrotising pancreatitis (PANTER trial): design and rationale of a randomised controlled multicenter trial [ISRCTN13975868]. BMC Surg. 2006;6:6.CrossRefGoogle Scholar
  67. 67.
    Logue JA, Carter CR. Minimally invasive necrosectomy techniques in severe acute pancreatitis: role of percutaneous necrosectomy and video-assisted retroperitoneal debridement. Gastroenterol Res Pract. 2015;2015:693040.CrossRefGoogle Scholar
  68. 68.
    Gomatos IP, Halloran CM, Ghaneh P, Raraty MG, Polydoros F, Evans JC, et al. Outcomes from minimal access retroperitoneal and open pancreatic necrosectomy in 394 patients with necrotizing pancreatitis. Ann Surg. 2016;263:992–1001.CrossRefGoogle Scholar
  69. 69.
    Palanivelu C, Senthilkumar K, Madhankumar MV, Rajan PS, Shetty AR, Jani K, et al. Management of pancreatic pseudocyst in the era of laparoscopic surgery—experience from a tertiary centre. Surg Endosc. 2007;21:2262–7.CrossRefGoogle Scholar
  70. 70.
    Lerch MM, Stier A, Wahnschaffe U, Mayerle J. Pancreatic pseudocysts: observation, endoscopic drainage, or resection? Dtsch Arztebl Int. 2009;106:614–21.PubMedPubMedCentralGoogle Scholar
  71. 71.
    Palanivelu C, Shetty R, Jani K, Rajan PS, Sendhilkumar K, Parthasarthi R, et al. Laparoscopic lateral pancreaticojejunostomy: a new remedy for an old ailment. Surg Endosc. 2006;20:458–61.CrossRefGoogle Scholar
  72. 72.
    Kilburn DJ, Chiow AKH, Leung U, Siriwardhane M, Cavallucci DJ, Bryant R, et al. Early experience with laparoscopic Frey procedure for chronic pancreatitis: a case series and review of literature. J Gastrointest Surg. 2017;21:904–9.CrossRefGoogle Scholar
  73. 73.
    Palanivelu C, Ahluwalia JS, Parthasarathi R, Palanisami S, Vaithiswaran V, Rajapandian S, et al. Laparoendoscopic single-site lateral pancreaticojejunostomy. Pancreatology. 2011;11(5):500.CrossRefGoogle Scholar
  74. 74.
    Conlon KC, de Rooij T, van Hilst J, Abu Hidal M, Fleshman J, Talamonti M, et al. Minimally invasive pancreatic resections: cost and value perspectives. HPB (Oxford). 2017;19:225–33.CrossRefGoogle Scholar
  75. 75.
    Gavriilidis P, Lim C, Menahem B, Lahat E, Salloum C, Azoulay D. Robotic versus laparoscopic distal pancreatectomy—the first meta-analysis. HPB (Oxford). 2016;18:567–74.CrossRefGoogle Scholar
  76. 76.
    Huang B, Feng L, Zhao J. Systematic review and meta-analysis of robotic versus laparoscopic distal pancreatectomy for benign and malignant pancreatic lesions. Surg Endosc. 2016;30:4078–85.CrossRefGoogle Scholar
  77. 77.
    Shakir M, Boone BA, Polanco PM, Zenati MS, Hogg ME, Tsung A, et al. The learning curve for robotic distal pancreatectomy: an analysis of outcomes of the first 100 consecutive cases at a high-volume pancreatic Centre. HPB (Oxford). 2015;17:580–6.CrossRefGoogle Scholar
  78. 78.
    Kornaropoulos M, Moris D, Beal EW, Makris MC, Mitrousias A, Petrou A, et al. Total robotic pancreaticoduodenectomy: a systematic review of the literature. Surg Endosc. 2017;31:4382–92.CrossRefGoogle Scholar
  79. 79.
    Buchs NC, Addeo P, Bianco FM, Ayloo S, Benedetti E, Giulianotti PC. Robotic versus open pancreaticoduodenectomy: a comparative study at a single institution. World J Surg. 2011;35:2739–46.CrossRefGoogle Scholar
  80. 80.
    Peng L, Lin S, Li Y, Xiao W. Systematic review and meta-analysis of robotic versus open pancreaticoduodenectomy. Surg Endosc. 2017;31:3085–97.CrossRefGoogle Scholar
  81. 81.
    McMillan MT, Zureikat AH, Hogg ME, Kowalsky SJ, Zeh HJ, Sprys MH, et al. A propensity score-matched analysis of robotic vs open pancreatoduodenectomy on incidence of pancreatic fistula. JAMA Surg. 2017;152:327–35.CrossRefGoogle Scholar
  82. 82.
    Røsok BI, de Rooij T, van Hilst J, Diener MK, Allen PJ, Vollmer CM, Organizing Committee for the State of the Art Conference on Minimally Invasive Pancreas Resection, et al. Minimally invasive distal pancreatectomy. HPB (Oxford). 2017;19:205–14.CrossRefGoogle Scholar
  83. 83.
    Qin H, Qiu J, Zhao Y, Pan G, Zeng Y. Does minimally-invasive pancreaticoduodenectomy have advantages over its open method? A meta-analysis of retrospective studies. PLoS One. 2014;9:e104274.CrossRefGoogle Scholar
  84. 84.
    Umemura A, Nitta H, Takahara T, Hasegawa Y, Sasaki A. Current status of laparoscopic pancreaticoduodenectomy and pancreatectomy. Asian J Surg. 2018;41(2):106–14.CrossRefGoogle Scholar
  85. 85.
    Croome KP, Farnell MB, Que FG, Reid-Lombardo KM, Truty MJ, Nagorney DM, et al. Total laparoscopic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: oncologic advantages over open approaches? Ann Surg. 2014;260:633–8.CrossRefGoogle Scholar
  86. 86.
    Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc. 2006;20:1045–50.CrossRefGoogle Scholar
  87. 87.
    Song KB, Kim SC, Park KM, Hwang DW, Lee JH, Lee DJ, et al. Laparoscopic central pancreatectomy for benign or low-grade malignant lesions in the pancreatic neck and proximal body. Surg Endosc. 2015;29:937–46.CrossRefGoogle Scholar
  88. 88.
    Casadei R, Marchegiani G, Laterza M, Ricci C, Marrano N, Margiotta A, et al. Total pancreatectomy: doing it with a mini-invasive approach. JOP. 2009;10:328–31.PubMedGoogle Scholar
  89. 89.
    Dallemagne B, de Oliveira AT, Lacerda CF, D’Agostino J, Mercoli H, Marescaux J. Full laparoscopic total pancreatectomy with and without spleen and pylorus preservation: a feasibility report. J Hepatobiliary Pancreat Sci. 2013;20:647–53.CrossRefGoogle Scholar
  90. 90.
    Boggi U, Palladino S, Massimetti G, Vistoli F, Caniglia F, De Lio N, et al. Laparoscopic robot-assisted versus open total pancreatectomy: a case-matched study. Surg Endosc. 2015;29:1425–32.CrossRefGoogle Scholar

Copyright information

© Indian Association of Surgical Gastroenterology 2018

Authors and Affiliations

  • P. Senthilnathan
    • 1
  • S. Srivatsan Gurumurthy
    • 1
  • C. Palanivelu
    • 2
  1. 1.Division of Minimally Invasive, Liver Transplant and HPB SurgeryGEM Centre for Liver and Pancreas, GEM Hospital and Research CentreCoimbatoreIndia
  2. 2.Institute of Gastroenterology and Minimal Access Surgery, GEM Hospital and Research CentreCoimbatoreIndia

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