Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 167] Initial Experience with Complete Laparoscopic Pancreaticoduodenectomy for Periampullary Malignancy: Insights from a Junior/Young Surgical Team at a University Hospital
Akshay ANAND 1, Awanish KUMAR 1, Abhinav Arun SONKAR 1, Kushagra GAURAV 1, Sandeep VERMA 1, Ajay Kumar PAL 1, Manish AGRAWAL 1, Harvinder S PAHWA 1, Amit KARNIK 1, Nizamuddin ANSARI 1, Ankita BAJPAI 1
1 Surgery (General), King George Medical University UP Lucknow, INDIA
Background : Laparoscopic pancreaticoduodenectomy (LPD) is an intricate surgical procedure that has yet to garner widespread acceptance. This study aimed to assess the safety, feasibility, and clinical benefits of LPD in comparison to open pancreaticoduodenectomy (OPD) for managing periampullary malignant lesions.
Methods : A prospective analysis (intraoperative, postoperative, and short-term complication data) of n=5 LPD procedures performed between January 2018 and December 2023 was conducted. The surgical team, consisting of two surgeons below 40 years of age, each with over 20 open pancreaticoduodenectomies and more than 5 years of laparoscopic experience, utilized a 6-trocar technique. A 30° scope with Full HD/4K technology provided vision during both the resection and reconstruction phases.
Results : All patients underwent successful laparoscopic procedures without conversion. N=4 cases involved distal cholangiocarcinoma, and n=1 presented ampullary malignancy. Histopathological analysis revealed negative resection margins in all cases. Preoperative endo-biliary drainage was performed in 3 out of 5 patients. Postoperative complications included biochemical leak (n=2), Pancreatic Fistula (Class B, n=1), delayed gastric emptying (n=2), and no instances of haemorrhage. Median operative time was 580 minutes (540 mins – 780 mins), and median blood loss was 450 ml (380-800ml). The mean hospital stay was 8 days, with a median return-to-work duration of 3 weeks.
Conclusions : LPD exhibits promising short-term outcomes, notably reduced hospital stay and blood loss, albeit with a prolonged operative time. Continued advancements and increasing experience with LPD are anticipated to further enhance overall procedural efficiency and patient outcomes.
Methods : A prospective analysis (intraoperative, postoperative, and short-term complication data) of n=5 LPD procedures performed between January 2018 and December 2023 was conducted. The surgical team, consisting of two surgeons below 40 years of age, each with over 20 open pancreaticoduodenectomies and more than 5 years of laparoscopic experience, utilized a 6-trocar technique. A 30° scope with Full HD/4K technology provided vision during both the resection and reconstruction phases.
Results : All patients underwent successful laparoscopic procedures without conversion. N=4 cases involved distal cholangiocarcinoma, and n=1 presented ampullary malignancy. Histopathological analysis revealed negative resection margins in all cases. Preoperative endo-biliary drainage was performed in 3 out of 5 patients. Postoperative complications included biochemical leak (n=2), Pancreatic Fistula (Class B, n=1), delayed gastric emptying (n=2), and no instances of haemorrhage. Median operative time was 580 minutes (540 mins – 780 mins), and median blood loss was 450 ml (380-800ml). The mean hospital stay was 8 days, with a median return-to-work duration of 3 weeks.
Conclusions : LPD exhibits promising short-term outcomes, notably reduced hospital stay and blood loss, albeit with a prolonged operative time. Continued advancements and increasing experience with LPD are anticipated to further enhance overall procedural efficiency and patient outcomes.
SESSION
E-poster
E-Session 03/21 ALL DAY