Skip to main content

Minimally Invasive Pancreatic Surgery for Cystic Tumors of the Pancreas

  • Chapter
  • First Online:
Cystic Tumors of the Pancreas

Abstract

Minimizing invasiveness is prevalent in nearly all aspects of surgery, and pancreatic surgery is no exception. Over the last two decades, laparoscopic pancreatic surgery has transitioned from experimental to becoming accepted within the standard of care, for procedures ranging from enucleation of pancreatic masses to distal pancreatectomy and, more recently, pancreaticoduodenectomy. Most reports of minimally invasive pancreatic surgery remain small, and thus few focus specifically on cystic neoplasms, but rather combine patients who received similar surgeries for a variety of indications. Cystic tumors of the pancreas lend themselves to minimally invasive management because they typically lack invasiveness to surrounding organs, are removed prophylactically in younger patients, and can be easily visualized laparoscopically.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience. Arch Surg. 2010;145:19–23. doi:10.1001/archsurg.2009.243.

    Article  PubMed  Google Scholar 

  2. 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. doi:10.1016/j.jamcollsurg.2012.08.006.

    Article  PubMed  Google Scholar 

  3. 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. doi:10.1007/s00464-012-2427-9.

    Article  PubMed  Google Scholar 

  4. 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;260:633–40. doi:10.1097/SLA.0000000000000937.

    Article  PubMed  Google Scholar 

  5. Chalikonda S, Aguilar-Saavedra JR, Walsh RM. Laparoscopic robotic-assisted pancreaticoduodenectomy: a case-matched comparison with open resection. Surg Endosc. 2012;26:2397–402. doi:10.1007/s00464-012-2207-6.

    Article  CAS  PubMed  Google Scholar 

  6. Song KB, Kim SC, Park JB, Kim YH, Jung YS, Kim MH, et al. Sing-center experience of laparoscopic left pancreatic resection in 359 consecutive patients: changing the surgical paradigm of left pancreatic resection. Surg Endosc. 2011;25:3364–72. doi:10.1007/s00464-011-1727-9.

    Article  PubMed  Google Scholar 

  7. Oken MM, Creech RH, Tormey DC, Horton J, David TE, McFadden ET, et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol. 1982;5:649–55.

    Article  CAS  PubMed  Google Scholar 

  8. Yao D, Wu S, Li Y, Chen Y, Yu X, Han J. Transumbilical single-incision laparoscopic distal pancreatectomy: preliminary experience and comparison to conventional multi-port laparoscopic surgery. BMC Surg. 2014;14:105. doi:10.1186/1471-2482-14-105.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Waters JA, Canal DF, Wiebke EA, Dumas RP, Beane JD, Aguilar-Saavedra JR, et al. Robotic distal pancreatectomy: cost effective? Surgery. 2010;148:814–23. doi:10.1016/j.surg.2010.07.027.

    Article  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. Lennon AM, Newman N, Makary MA, Edil BH, Shin EJ, Khashab MA, et al. EUS-guided tattooing before laparoscopic distal pancreatic resection (with video). Gastrointest Endosc. 2010;72:1089–94. doi:10.1016/j.gie.2010.07.023.

    Article  PubMed  Google Scholar 

  12. Kuroki T, Tajima Y, Kitasato A, Adachi T, Kanematsu T. Pancreas-hanging maneuver in laparoscopic pancreaticoduodenectomy: a new technique for the safe resection of the pancreas head. Surg Endosc. 2010;24:1781–3. doi:10.1007/s00464-009-0814-7.

    Article  PubMed  Google Scholar 

  13. 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. doi:10.1007/s00534-009-0157-8.

    Article  CAS  PubMed  Google Scholar 

  14. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc. 2006;20:1045–50.

    Article  CAS  PubMed  Google Scholar 

  15. Lee SY, Allen PJ, Sadot E, D’Angelica MI, DeMatteo RP, Fong Y, et al. Distal pancreatectomy: a single institution’s experience in open, laparoscopic, and robotic approaches. J Am Coll Surg. 2015;220:18–27. doi:10.1016/j.jamcollsurg.2014.10.004.

    Article  PubMed  Google Scholar 

  16. Song KB, Kim SC, Park KM, H Nakamura 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(4):937–46.

    Google Scholar 

  17. Iacobone M, Citton M, Nitti D. Laparoscopic distal pancreatectomy: up-to-date and literature review. World J Gastroenterol. 2012;18:5329–37. doi:10.3748/wjg.v18.i38.5329.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Weber SM, Cho CS, Merchant N, Pinchot S, Rettammel R, Nakeeb A, et al. Laparoscopic left pancreatectomy: complication risk score correlates with morbidity and risk for pancreatic fistula. Ann Surg Oncol. 2009;16:2825–33. doi:10.1245/s10434-009-0597-z.

    Article  PubMed  Google Scholar 

  19. Kang CM, Chung YE, Jung MJ, Hwang HK, Choi SH, Lee WJ. Splenic vein thrombosis and pancreatic fistula after minimally invasive distal pancreatectomy. BJS. 2014;101:114–9. doi:10.1002/bjs.9366.

    Article  CAS  Google Scholar 

  20. Tran Cao HS, Lopez N, Chang DC, Lowy AM, Bouvet M, Baumgartner JM, et al. Improved perioperative outcomes with minimally invasive distal pancreatectomy: results from a population-based analysis. JAMA Surg. 2014;149:237–43. doi:10.1001/jamasurg.2013.3202.

    Article  PubMed  Google Scholar 

  21. Mabrut JY, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, et al. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005;137:597–605.

    Article  PubMed  Google Scholar 

  22. Gumbs AA, Croner R, Rodriguez A, Zuker N, Perrakis A, Gayet B. 200 Consecutive laparoscopic pancreatic resections performed with a robotically controlled laparoscope holder. Surg Endosc. 2013;27:3781–91. doi:10.1007/s00464-013-2969-5.

    Article  PubMed  Google Scholar 

  23. Sui CJ, Li B, Yang JM, Wang SJ, Zhou YM. Laparoscopic versus open distal pancreatectomy: a meta-analysis. Asian J Surg. 2012;351:1–8. doi:10.1016/j.asjsur.2012.04.001.

    Article  Google Scholar 

  24. Worhunsky DJ, Zak Y, Dua MM, Poultsides GA, Norton JA, Visser BC. Laparoscopic spleen-preserving distal pancreatectomy: the technique must suit the lesion. J Gastrointest Surg. 2014;18:1445–51. doi:10.1007/s11605-014-2561-x.

    Article  PubMed  Google Scholar 

  25. Ferrone CR, Konstantinidis IT, Sahani DV, Wargo JA, Fernandez-del Castillo C, Warshaw AL. Twenty-three years of the Warshaw operation for distal pancreatectomy with preservation of the spleen. Ann Surg. 2011;253:1136–9. doi:10.1097/SLA.0b013e318212c1e2.

    Article  PubMed  Google Scholar 

  26. Stewart CL, Raeburn C, Edil BH. Laparoscopic distal pancreatectomy for an ACTH secreting pancreatic neuroendocrine tumor. VideoEndocrinology. 2015;2:4. doi:10.1089/ve.2015.0049.

  27. D’Angelica M, Are C, Jarnagin W, DeGregoris G, Coit D, Jaques D, et al. Initial experience with hand-assisted laparoscopic distal pancreatectomy. Surg Endosc. 2006;20:142–8.

    Article  PubMed  Google Scholar 

  28. Abe N, Mori T, Sugiyama M. Tips on laparoscopic distal pancreatectomy. J Hepatobiliary Pancreat Sci. 2014;21:e41–7. doi:10.1002/jhbp.95.

    Article  PubMed  Google Scholar 

  29. Sartori CA, Baiocchi GL. Transecting the pancreas neck with electrothermal bipolar vessel sealer (Ligasure) in laparoscopic left pancreatectomy. Surg Laparosc Endosc Percutan Tech. 2009;19:e175–6. doi:10.1097/SLE.0b013e3181b8fb3c.

    Article  PubMed  Google Scholar 

  30. Suzuki O, Nakamura F, Ambo Y, Nakamura T, Kishida A, Kashimura N. Lesser curvature approach in laparoscopic distal pancreatectomy. Surg Laparosc Endosc Percutan Tech. 2013;232:e57–60. doi:10.1097/SLE.0b013e31828a0b3f.

    Article  Google Scholar 

  31. Giulianotti PC, Sbrana F, Bianco FM, Elli EF, Shah G, Addeo P, et al. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc. 2010;24:1646–57. doi:10.1007/s00464-009-0825-4.

    Article  PubMed  Google Scholar 

  32. Haugvik SP, Rosok BI, Waage A, Mathisen O, Edwin B. Single-incision versus conventional laparoscopic distal pancreatectomy: a single-institution case–control study. Langenbecks Arch Surg. 2013;398:1091–6. doi:10.1007/s00423-013-1133-y.

    Article  PubMed  Google Scholar 

  33. 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. doi:10.1007/s00464-011-2090-6.

    Article  PubMed  Google Scholar 

  34. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreaticoduodenectomy. Surg Endosc. 1994;8:408–10.

    Article  CAS  PubMed  Google Scholar 

  35. 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. 2014. doi:10.1007/s11605-014-2644-8.

    PubMed  Google Scholar 

  36. Speicher PJ, Nussbaum DP, White RR, Zani S, Mosca PJ, Blazer III DG, et al. Defining the learning curve for team-based laparoscopic pancreaticoduodenectomy. Ann Surg Oncol. 2014;21:4014–9. doi:10.1245/s10434-014-3839-7.

    Article  PubMed  Google Scholar 

  37. Paniccia A, Schulick RD, Edil BH. Total laparoscopic pancreaticoduodenectomy: a single-institutional experience. Ann Surg Oncol. 2015. 22(13):4380–1.

    Google Scholar 

  38. Suzuki O, Kondo S, Hirano S, Tanaka E, Kato K, Tsuchikawa T, et al. Laparoscopic pancreaticoduodenectomy combined with minilaparotomy. Surg Today. 2012;42:509–13. doi:10.1007/s00595-011-0064-x.

    Article  PubMed  Google Scholar 

  39. Wang Y, Bergman S, Piedimonte S, Vanounou T. Bridging the gap between open and minimally invasive pancreaticoduodenectomy: the hybrid approach. Can J Surg. 2014;57:263–70.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Nakamura Y, Matsumoto S, Yoshioka M, Shimizu T, Yamahatsu K, Uchida E. Successful laparoscopic pancreaticoduodenectomy for intraductal papillary mucinous neoplasm: a case report and a reliable technique for pancreaticojejunostomy. J Nippon Med Sch. 2012;793:218–22.

    Article  Google Scholar 

  41. Ogiso S, Conrad C, Araki K, Basso V, Bayet B. Posterior approach for laparoscopic pancreaticoduodenectomy to prevent replaced hepatic artery injury. Ann Surg Oncol. 2013;20:3120. doi:10.1245/s10434-013-3058-7.

    Article  PubMed  Google Scholar 

  42. Keck T, Kusters S, Wellner UF, Hopt UT, Karcz KW. Total laparoscopic partial pancreatoduodenectomy and reconstruction via laparoscopic pancreatogastrostomy. Langenbecks Arch Surg. 2012;397:1009–12. doi:10.1007/s00423-012-0964-2.

    Article  PubMed  Google Scholar 

  43. Orti-Rodriguez RJ, Rahman SH. A comparative review between laparoscopic and robotic pancreaticoduodenectomies. Surg Laparosc Endosc Percutan Tech. 2014;24:103–8. doi:10.1097/SLE.0b013e3182a2f0ad.

    Article  PubMed  Google Scholar 

  44. Qin H, Qui 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. doi:10.1371/journal.pone.0104274.

    Article  PubMed  PubMed Central  Google Scholar 

  45. Langan RC, Graham JA, Chin AB, Rubinstein AJ, Oza K, Nusbaum JA, et al. Laparoscopic-assisted versus open pancreaticoduodenectomy: early favorable physical quality-of-life measures. Surgery. 2014;156:379–84. doi:10.1016/j.surg.2014.03.018.

    Article  PubMed  Google Scholar 

  46. Mesleh MG, Stauffer JA, Bowers SP, Asbun HJ. Cost analysis of open and laparoscopic pancreaticoduodenectomy: a single institution comparison. Surg Endosc. 2013;27:4518–23. doi:10.1007/s00464-013-3101-6.

    Article  PubMed  Google Scholar 

  47. Kendrick ML, Sclabas GM. Major venous resection during total laparoscopic pancreaticoduodenectomy. HPB. 2011;13:454–8. doi:10.1111/j.1477-2574.2011.00323.x.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Young S, Abbitt P, Hughes SJ. Port-site recurrence of pancreatic adenocarcinoma following laparoscopic pancreaticoduodenectomy. J Gastrointest Surg. 2012;16:2294–6. doi:10.1007/s11605-012-2050-z.

    Article  PubMed  Google Scholar 

  49. Kuroki T, Eguchi S. Laparoscopic parenchyma-sparing pancreatectomy. J Hepatobiliary Pancreat Sci. 2014;21:323–7. doi:10.1002/jhbp.29.

    Article  PubMed  Google Scholar 

  50. DiNorcia J, Lee MK, Reavey PL, Genkinger JM, Lee JA, Schrope BA, et al. One hundred and thirty resections for pancreatic neuroendocrine tumor: evaluating the impact of minimally invasive and parenchyma-sparing techniques. J Gastrointest Surg. 2010;14:1536–46. doi:10.1007/s11605-010-1319-3.

    Article  PubMed  Google Scholar 

  51. 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. doi:10.1007/s00464-014-3756-7.

    Article  PubMed  Google Scholar 

  52. Balzano G, Carvello M, Piemonti L, Nano R, Ariotti R, Mercalli A, et al. Combined laparoscopic spleen-preserving distal pancreatectomy and islet autotransplantation for benign pancreatic neoplasm. World J Gastroenterol. 2014;20:4030–6. doi:10.3748/wjg.v20.i14.4030.

    Article  PubMed  PubMed Central  Google Scholar 

  53. Sokolov YY, Stronogin SV, Donskoy DV, Povarnin OY, Vilesov AV. Laparoscopic pancreatic resections for solid pseudopapillary tumor in children. Eur J Pediatr Surg. 2009;19:399–401. doi:10.1055/s-0029-1237356.

    Article  CAS  PubMed  Google Scholar 

  54. Thakkar S, Awad M, Gurram KC, Tully S, Wright C, Sanan S, et al. A novel, new robotic platform for natural orifice distal pancreatectomy. Surg Innov. 2015. 22(3):274–82.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Barish H. Edil MD, FACS .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Stewart, C.L., Edil, B.H. (2016). Minimally Invasive Pancreatic Surgery for Cystic Tumors of the Pancreas. In: Del Chiaro, M., Haas, S., Schulick, R. (eds) Cystic Tumors of the Pancreas. Springer, Cham. https://doi.org/10.1007/978-3-319-31882-0_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-31882-0_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-31880-6

  • Online ISBN: 978-3-319-31882-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics