Laparoscopic duodenum-preserving pancreatic head resection: a narrative review

Nuerabula Wujimaimaiti, Yi Wu, J. Yuan, Jikuan Jin, Hebin Wang, Shizhen Li, Hang Zhang, Min Wang, R. Qin
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Abstract

Abstract Pancreatic surgery is one of the most complex and challenging fields in abdominal surgery associated with extensive surgical trauma, damage to adjacent organs, a long operation time and a high incidence of postoperative complications. Since the early 1990s, laparoscopic techniques have been applied to a growing number of pancreas surgeries, and great progress has been achieved in laparoscopic pancreaticoduodenectomy. As surgeons become proficient in laparoscopic pancreaticoduodenectomy techniques, laparoscopic techniques are gradually used in other pancreatic surgeries, such as laparoscopic distal pancreatectomies and laparoscopic duodenum-preserving pancreatic head resection (LDPPHR), which may benefit patients by reducing postoperative pain and hospital stays and providing a quick recovery to normal activity. Recently, a great number of literature have introduced LDPPHR. It is a good surgical method for benign and low-grade malignant tumors of the pancreatic head. Although LDPPHR is technically feasible, it is not yet generally practicable and limited to highly skilled endoscopic surgeons, and the long-term results after LDPPHR are still not well defined. This article aims to provide a literature review of LDPPHR to assess its feasibility, safety, postoperative recovery, and future outlook according to early experiences of this technique.
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腹腔镜保留十二指肠胰头切除术
胰腺手术是腹部外科手术中最复杂、最具挑战性的领域之一,手术创伤大、邻近脏器受损、手术时间长、术后并发症发生率高。20世纪90年代初以来,腹腔镜技术应用于越来越多的胰腺手术,腹腔镜胰十二指肠切除术取得了很大进展。随着外科医生对腹腔镜胰十二指肠切除术技术的熟练,腹腔镜技术逐渐应用于其他胰腺手术,如腹腔镜远端胰腺切除术和腹腔镜保留十二指肠胰头切除术(LDPPHR),可以减少患者术后疼痛和住院时间,并使患者迅速恢复正常活动。近年来,大量文献对LDPPHR进行了介绍。是治疗胰头良性及低度恶性肿瘤的良好手术方法。虽然LDPPHR在技术上是可行的,但目前尚未普遍可行,仅限于高技能的内镜外科医生,LDPPHR术后的长期效果仍不明确。本文旨在根据LDPPHR的早期经验,对其可行性、安全性、术后恢复情况及未来前景进行文献综述。
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