caa a22 4500 445336811 CHVBK 20180317142758.0 cr unu---uuuuu 170323e20110501xx s 000 0 eng 10.1245/s10434-010-1503-4 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1503-4 Laparoscopic Pancreatoduodenectomy: A Review of 285 Published Cases [Elektronische Daten] [Andrew Gumbs, Angel Rodriguez Rivera, Luca Milone, John Hoffman] Background: Given the difficulty level of minimally invasive pancreatoduodenectomy (MIPD), limited data exist for a comparison to open pancreatoduodenectomies. As the technique becomes more diffuse, issues regarding the adequacy of oncologic margins and lymph node retrieval need to be addressed. Methods: All published cases of MIPD were examined. Variables analyzed included conversion rates, operating room time, estimated blood loss, length of stay, follow-up, complications, mortality, lymph node retrieval, and margins. Results: Twenty-seven articles describing outcomes after MIPD were found, and a total of 285 cases were described. Main malignancy treated was pancreatic adenocarcinoma, accounting for 32% of all cases. Eighty-seven percent were performed totally laparoscopically, and 13% were performed with a hand-assisted approach to facilitate the reconstruction step of the procedure. The rate of conversion to an open procedure was 9%. Estimated blood loss had a weighted average (WA) of 189mL. Average length of stay had a WA of 12days, and average follow-up had a WA of 14months. The overall complication rate was 48%, and the overall mortality rate was 2%. Average lymph nodes retrieved ranged from 7 to 36 nodes, with a WA of 15 nodes, and positive margins of resection were reported to be positive in 0.4% of patients with malignant disease. Conclusions: This review found similar outcomes with respect to perioperative morbidity and mortality rates compared to open pancreatoduodenectomies. The oncologic goals of pancreatic resection may be able to be achieved by MIPD, but longer follow-up and larger series are still needed. Society of Surgical Oncology, 2010 Gumbs Andrew Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut Rodriguez Rivera Angel Department of Surgery, Mercy Catholic Medical Center, Philadelphia, PA, USA aut Milone Luca Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut Hoffman John Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1335-1341 1068-9265 18:5<1335 2011 18 10434 https://doi.org/10.1245/s10434-010-1503-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1503-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Gumbs Andrew Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Rodriguez Rivera Angel Department of Surgery, Mercy Catholic Medical Center, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Milone Luca Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut NATIONALLICENCE 700 1- Hoffman John Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/5(2011-05-01), 1335-1341 1068-9265 18:5<1335 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer