Systematic Review of Minimally Invasive Pancreatic Resection

BackgroundPancreatic resection is associated with a significant morbidity. Efforts to reduce hospital stay and enhance recovery have seen the introduction of minimally invasive surgical techniques. This article reviews the current published literature on the safety and efficacy of minimally invasive surgery of the pancreas.MethodsAn electronic search of the PubMed and Embase databases was performed from 1996 to May 2008 to identify all relevant publications; studies meeting predefined inclusion criteria were retrieved and analyzed using a standardized protocol. Data on the safety and efficacy of minimally invasive surgery of the pancreas were recorded and analyzed.ResultsOf 565 abstracts reviewed, 39 studies were identified as eligible for inclusion. There were 37 case series and two case control studies. Compared with open pancreatic surgery, minimally invasive pancreatic resection is similar in terms of morbidity and mortality. Blood loss and length of stay are decreased.ConclusionsLaparoscopic distal pancreatic resection and enucleation of insulinoma appear to be safe procedures with reduced hospital stay, though morbidity remains significant. The evidence for laparoscopic pancreaticoduodenectomy is in its infancy, but the authors feel it is unlikely that many centers will achieve sufficient case load to make the introduction of minimally invasive resection feasible.

[1]  A. Goldenberg,et al.  Laparoscopic enucleation of pancreatic insulinomas. , 2007, Journal of laparoendoscopic & advanced surgical techniques. Part A.

[2]  G. Delvaux,et al.  Neuroendocrine tumors of the pancreas , 2003, Surgical Endoscopy.

[3]  T. Misawa,et al.  Systemic inflammatory response syndrome after hand-assisted laparoscopic distal pancreatectomy , 2007, Surgical Endoscopy.

[4]  G. Zamboni,et al.  Results of pancreaticoduodenectomy for pancreatic cancer: Extended versus standard procedure , 2002, World Journal of Surgery.

[5]  B. Edwin,et al.  Laparoscopic resection of the pancreas: a feasibility study of the short-term outcome , 2004, Surgical Endoscopy And Other Interventional Techniques.

[6]  M. Herrera,et al.  Videolaparoscopic Resection of Insulinomas: Experience in Two Institutions , 2002, World Journal of Surgery.

[7]  M. D'Angelica,et al.  Initial experience with hand-assisted laparoscopic distal pancreatectomy , 2005, Surgical Endoscopy And Other Interventional Techniques.

[8]  S. Kim,et al.  Laparoscopic distal pancreatectomy with preservation of the spleen and splenic vessels for benign Pancreas neoplasm , 2005, Surgical Endoscopy And Other Interventional Techniques.

[9]  R. Schwetling,et al.  Laparoscopic Resection of the Left Pancreas: Technique and Indication , 2002, Digestive Surgery.

[10]  C. Tang,et al.  Laparoscopic distal pancreatectomy: a comparative study. , 2007, Hepato-gastroenterology.

[11]  K. Lillemoe,et al.  Central pancreatectomy with pancreaticogastrostomy for benign pancreatic pathology , 2004, Journal of Gastrointestinal Surgery.

[12]  F. Pirozzi,et al.  Distal pancreas surgery: outcome for 19 cases managed with a laparoscopic approach , 2006, Surgical Endoscopy And Other Interventional Techniques.

[13]  R. Pierce,et al.  Outcomes analysis of laparoscopic resection of pancreatic neoplasms , 2007, Surgical Endoscopy.

[14]  L. Fernández‐Cruz,et al.  Curative Laparoscopic Resection for Pancreatic Neoplasms: A Critical Analysis from a Single Institution , 2007, Journal of Gastrointestinal Surgery.

[15]  J. Périssat,et al.  Are major laparoscopic pancreatic resections worthwhile? A prospective study of 32 patients in a single institution , 2005, Surgical Endoscopy And Other Interventional Techniques.

[16]  M. Talamini,et al.  Six hundred fifty consecutive pancreaticoduodenectomies in the 1990s: pathology, complications, and outcomes. , 1997, Annals of surgery.

[17]  C. Vacher,et al.  Is laparoscopic left pancreatic resection justified? , 2002, Surgical Endoscopy And Other Interventional Techniques.

[18]  T. Obara,et al.  Recent advances in minimally invasive pancreatic surgery. , 2003, Asian journal of surgery.

[19]  K. Gurusamy,et al.  Meta‐analysis of randomized controlled trials on the safety and effectiveness of day‐case laparoscopic cholecystectomy , 2008, The British journal of surgery.

[20]  V. Velanovich.  The lasso technique for laparoscopic distal pancreatectomy , 2006, Surgical Endoscopy And Other Interventional Techniques.

[21]  G. Guyatt,et al.  The Pylorus: Take It or Leave It? Systematic Review and Meta-Analysis of Pylorus-Preserving versus Standard Whipple Pancreaticoduodenectomy for Pancreatic or Periampullary Cancer , 2007, Annals of Surgical Oncology.

[22]  C. Bassi,et al.  Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. , 2005, Surgery.

[23]  E. Kuhry,et al.  Long-term outcome of laparoscopic surgery for colorectal cancer: a cochrane systematic review of randomised controlled trials. , 2008, Cancer treatment reviews.

[24]  C. Peng,et al.  Strategy for the Surgical Management of Insulinomas: Analysis of 52 Cases , 2007, Digestive Surgery.

[25]  L. Fernández‐Cruz,et al.  Laparoscopic pancreatic surgery in patients with chronic pancreatitis , 2002, Surgical Endoscopy And Other Interventional Techniques.

[26]  T. Misawa,et al.  Safe and quick distal pancreatectomy using a staggered six-row stapler. , 2008, American journal of surgery.

[27]  A. Mahajna,et al.  Laparoscopic pancreaticoduodenectomy for benign and malignant diseases , 2006, Surgical Endoscopy And Other Interventional Techniques.

[28]  M. Gagner,et al.  Laparoscopic pancreatic resection: single-institution experience of 19 patients. , 2001, Journal of the American College of Surgeons.

[29]  V. Velanovich.  Case-control comparison of laparoscopic versus open distal pancreatectomy , 2005, Journal of Gastrointestinal Surgery.

[30]  R. Schlinkert,et al.  Laparoscopic localization and resection of insulinomas. , 2004, Archives of surgery.

[31]  Luisangel Rondon,et al.  Laparoscopic resection of the pancreatic tail with splenic preservation. , 2006, American journal of surgery.

[32]  A. Parvaiz,et al.  Laparoscopic resection for colorectal cancer , 2008, The British journal of surgery.

[33]  R. Surendran,et al.  CENTRAL PANCREATECTOMY FOR BENIGN PANCREATIC PATHOLOGY/TRAUMA: IS IT A REASONABLE PANCREAS‐PRESERVING CONSERVATIVE SURGICAL STRATEGY ALTERNATIVE TO STANDARD MAJOR PANCREATIC RESECTION? , 2006, ANZ journal of surgery.

[34]  Sabine Siesling,et al.  Recent trends of cancer in Europe: a combined approach of incidence, survival and mortality for 17 cancer sites since the 1990s. , 2008, European journal of cancer.

[35]  F. Papadia,et al.  D1 versus D2 pancreatoduodenectomy in surgical therapy of pancreatic head cancer. , 2001, Hepato-gastroenterology.

[36]  P. Senthilnathan,et al.  Laparoscopic pancreaticoduodenectomy: technique and outcomes. , 2007, Journal of the American College of Surgeons.

[37]  A. Park,et al.  Therapeutic Laparoscopy of the Pancreas , 2002, Annals of surgery.

[38]  P. S. Rajan,et al.  Laparoscopic distal pancreatectomy , 2007, Surgical Endoscopy.

[39]  M. Talamini,et al.  Cystadenomas of the pancreas: is enucleation an adequate operation? , 1998, Annals of surgery.

[40]  M. Gagner,et al.  Early experience with laparoscopic resections of islet cell tumors. , 1996, Surgery.

[41]  A. Cuschieri,et al.  Laparoscopic distal 70% pancreatectomy and splenectomy for chronic pancreatitis. , 1996, Annals of surgery.

[42]  K. Lillemoe,et al.  Distal pancreatectomy: indications and outcomes in 235 patients. , 1999, Annals of surgery.

[43]  Xiao-yong Cai,et al.  Cancer of the ampulla of Vater , 1998 .

[44]  D. Collet,et al.  Laparoscopic central pancreatectomy: single institution experience of 6 patients. , 2007, Surgery.

[45]  A. Toniato,et al.  Laparoscopic Treatment of Benign Insulinomas Localized in the Body and Tail of the Pancreas: A Single-center Experience , 2006, World Journal of Surgery.

[46]  K. Mizumoto,et al.  Laparoscopic pancreatic surgery: Current indications and surgical results , 2004, Surgical Endoscopy And Other Interventional Techniques.

[47]  L. Way,et al.  Laparoscopic enucleation of insulinomas. , 2007, Archives of surgery.

[48]  A. Ayav,et al.  Laparoscopic approach for solitary insulinoma: a multicentre study , 2005, Langenbeck's Archives of Surgery.

[49]  S. Libutti,et al.  Operative management of islet-cell tumors arising in the head of the pancreas. , 1998, Surgery.

[50]  M. Büchler,et al.  Systematic review and meta‐analysis of technique for closure of the pancreatic remnant after distal pancreatectomy , 2005, The British journal of surgery.

[51]  Z. Pogorelić,et al.  Effect of surgical incision on pain and respiratory function after abdominal surgery: a randomized clinical trial. , 2007, Hepato-gastroenterology.

[52]  G. Kazemier,et al.  Laparoscopic detection and resection of insulinomas. , 2000, Surgery.

[53]  H. Gooszen,et al.  Laparoscopic versus open cholecystectomy for patients with symptomatic cholecystolithiasis. , 2006, The Cochrane database of systematic reviews.

[54]  A. Stojadinovic,et al.  An evidence-based approach to the surgical management of resectable pancreatic adenocarcinoma. , 2003, Journal of the American College of Surgeons.

[55]  A. Vezakis,et al.  Laparoscopic surgery combined with preservation of the spleen for distal pancreatic tumors , 1999, Surgical Endoscopy.

[56]  M. Gagner,et al.  Laparoscopic pancreatic resection: is it worthwhile? , 1997, Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract.