Laparoscopic-assisted pancreaticoduodenectomy for periampullary carcinoma: An experience of 50 cases from a single tertiary care center

Abstract

Objective: Laparoscopic-assisted pancreaticoduodenectomy (LAPD) is being performed in several centers worldwide. The proportion of minimally invasive pancreaticoduodenectomy for periampullary carcinoma (PAC) has recently increased, owing to its potential benefits. However, the safety and feasibility of LAPD have not yet been standardized. In this study, it was aimed to report our experience with LAPD in 50 patients. Material and Methods: Fifty patients with resectable PAC who underwent LAPD between June 2021 and August 2023 were retrospectively analyzed. Results: Mean age of the study group was 49.9 ± 12 years, and most were females (54%). Ampullary carcinoma was the most common type (58%). Mean operative time and estimated blood loss were 460 ± 40 minutes and 426 ± 156 mL, respectively. Four patients had suspected portal vein involvement, and two patients had hemorrhage during uncinate process dissection, resulting in conversion to open surgery. Severe post-operative morbidity was noted in 13 (26%) patients. Following surgery, Grade B post-operative pancreatic fistula was present in 26% of patients, whereas Grade B and C delayed gastric emptying was present in 18% and 2% of patients, respectively. Mean hospital stay was 9.4 ± 2.8 days. Mean number of lymph nodes harvested was 13.4 ± 4. All patients underwent R0 resection, and no mortality was noted during the 30-day follow-up period. Conclusion: LAPD is a feasible procedure for resectable PAC offering good oncological outcomes and minimal complications. It can be performed effectively by experienced surgeons in specialized centers.