Laparoscopic Pancreatic Resections
Part of the
M. D. Anderson Solid Tumor Oncology Series
book series (MDA)
Laparoscopic surgery has become the gold standard for the management of gallstones, gastroesophageal reflux disease, and achalasia. It is also the preferred approach for most adrenal and splenic pathology. Laparoscopic colectomy is being offered to an increasing number of patients with both benign and malignant diseases. In the past 15 years significant advances have been made in the application of minimally invasive techniques to the management of pancreatic disorders. However, the utility and indications for laparoscopic pancreatic resection is still under active evaluation and the technical aspects of these procedures remain in evolution.
Initially, laparoscopic pancreatic surgery was limited to diagnostic staging in patients with pancreatic cancer prior to resection. With recent advancements in laparoscopic instrumentation, an increasing number of surgeons are applying minimally invasive techniques to manage both inflammatory and neoplastic disorders of the pancreas. Currently, select patients with necrotizing pancreatitis and pancreatic pseudocysts can be managed with minimally invasive techniques. In addition, laparoscopic techniques to resect both benign and malignant lesions of the pancreas have been described ( 1 ).
Laparoscopic staging of pancreatic cancer was initially described in 1911 by Dr. Bertram M. Bernheim ( 2 ) and was reintroduced by Cuscheri and colleagues in 1978 (3). The first laparoscopic pancreatic resection was reported by Gagner and Pomp in 1994 ( 4 ). In recent years, laparoscopic pancreaticoduodenectomies (PD), enucleations (En), and distal pancreatectomies (DP) have all been described in the surgical literature.
KeywordsPancreatic Duct Distal Pancreatectomy Splenic Artery Intraductal Papillary Mucinous Neoplasm Splenic Vein
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