Two-surgeon Model in Laparoscopic Pancreaticoduodenectomy

Surg Laparosc Endosc Percutan Tech. 2019 Aug;29(4):275-279. doi: 10.1097/SLE.0000000000000649.

Abstract

Purpose: Laparoscopic pancreaticoduodenectomy (LPD) is one of the most challenging gastrointestinal surgeries. Herein, we propose a new laparoscopic surgical conception called the 2-surgeon model and share our experience in LPD.

Materials and methods: We began performing LPD using the 2-surgeon model in October 2015. To December 2017, we have performed 203 cases of LPDs using 2-surgeon model. Data associated with demographic characteristics, operative outcomes, and postoperative results were prospectively collected and analyzed retrospectively.

Results: Only 1 patient in our series required to conversion to open surgery. The mean operative time was 318 minute. The estimated blood loss was 108 mL. The overall complication was 26.1%. In total, 41 patients (20.2%) suffered from pancreatic fistula, including 33 cases of grade A, 7 cases of grade B, and 1 case of grade C. The 90-day mortality was 0.5%.

Conclusions: The 2-surgeon model is safe and feasible for LPD.

MeSH terms

  • Aged
  • Anastomosis, Surgical / methods
  • Cohort Studies
  • Conversion to Open Surgery / statistics & numerical data*
  • Female
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Models, Anatomic
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / adverse effects
  • Pancreaticoduodenectomy / methods*
  • Patient Positioning
  • Retrospective Studies
  • Risk Assessment
  • Survival Rate
  • Treatment Outcome