Laparoscopic pancreatectomy: indications and outcomes

Area of Science:

• Gastroenterology and Hepatology
• Surgical Oncology
• Minimally Invasive Surgery

Background:

• Minimally invasive surgical techniques for pancreatic resection have gained prominence over the past two decades.
• Laparoscopic distal pancreatectomy (LDP) is established as a safe and feasible procedure, often showing reduced blood loss and hospital stays compared to open surgery.
• Minimally invasive pancreaticoduodenectomy (MIPD) adoption is limited, with no definitive evidence of superiority over open procedures.

Purpose of the Study:

• To review the current status and outcomes of minimally invasive pancreatic resection techniques.
• To compare laparoscopic distal pancreatectomy (LDP) with open distal pancreatectomy.
• To assess the evidence for minimally invasive pancreaticoduodenectomy (MIPD) and robotic surgery in pancreatectomy.

Main Methods:

• Review of existing studies comparing minimally invasive (laparoscopic and robotic) and open pancreatic resection techniques.
• Analysis of outcomes including operative time, blood loss, length of hospital stay, and complication rates.
• Evaluation of safety and efficacy for specific procedures like LDP and laparoscopic enucleation.

Main Results:

• Laparoscopic distal pancreatectomy (LDP) demonstrates decreased blood loss and shorter hospital stays compared to open surgery, with similar complication and oncologic outcomes.
• LDP is increasingly preferred for benign or small, low-grade malignant distal pancreatic lesions.
• Evidence supporting minimally invasive pancreaticoduodenectomy (MIPD) over open surgery is currently lacking regarding key surgical outcomes.

Conclusions:

• Laparoscopic distal pancreatectomy (LDP) is a safe and effective option for specific pancreatic conditions.
• Further investigation and evidence are required to establish the benefits of minimally invasive pancreaticoduodenectomy (MIPD).
• Advancements in robotic surgery and growing surgeon expertise are expected to drive innovation in minimally invasive pancreatic procedures.