Abstract
Objective. To assess the role of minimally invasive surgery for periampullary cancer.Material and methods. A systematic literature review of original articles devoted to comparison of open, laparoscopic and robot-assisted pancreatoduodenectomy was performed. Also, our own experience of minimally invasive pancreatoduodenectomy is shown.Results. Articles included in the analysis showed comparable results of minimally invasive and open pancreatoduodenectomy regarding morbidity, mortality and oncological outcomes. Laparoscopic and robot-assisted pancreatoduodenectomy are associated with significantly less intraoperative blood loss and length of postoperative hospital-stay. However, these procedures require more time.Conclusion. Minimally invasive surgery does not worsen perioperative outcomes and may be considered as an alternative to open procedures in selective patients. Minimally invasive techniques should be implemented in highvolume pancreatic centers only with specialists experienced in minimally invasive surgery.
Highlights
Articles included in the analysis showed comparable results of minimally invasive and open pancreatoduodenectomy regarding morbidity, mortality and oncological outcomes
Laparoscopic and robot-assisted pancreatoduodenectomy are associated with significantly less intraoperative blood loss and length of postoperative hospital-stay
Chen S., Chen J.Z., Zhan Q., Deng X.X., Shen B.Y., Peng C.H., Li H.W. Robot-assisted laparoscopic versus open pancreaticoduodenectomy: a prospective, matched, mid-term follow-up study
Summary
To assess the role of minimally invasive surgery for periampullary cancer. Material and methods. Articles included in the analysis showed comparable results of minimally invasive and open pancreatoduodenectomy regarding morbidity, mortality and oncological outcomes. Laparoscopic and robot-assisted pancreatoduodenectomy are associated with significantly less intraoperative blood loss and length of postoperative hospital-stay. Invasive surgery does not worsen perioperative outcomes and may be considered as an alternative to open procedures in selective patients. Возможность применения технологий малого доступа (лапароскопических и робот-ассистированных) в радикальном лечении больных злокачественными опухолями органов гепатопанкреатодуоденальной зоны (ГПДЗ) является наиболее обсуждаемым вопросом на настоящем этапе развития хирургической панкреатологии. Недостаточный общий уровень владения навыками минимально инвазивных хирургических технологий (МИХТ), дефицит специализированных программ обучения и отсутствие доказательств однозначного превосходства над открытой ПДР (ОПДР) сдерживают широкое их распространение. В статье будут проанализированы мировые данные и представлены собственные результаты лапароскопической и робот-ассистированной панкреатодуоденальной резекции при раке органов ГПДЗ
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