Totally laparoscopic pancreaticoduodenectomy. First case reported in México

Abstract

Abstract Background Approximately 48,960 people in the USA will be diagnosed with pancreatic cancer in 2015 and 40,560 will die for this reason; in Mexico, the new cases of pancreatic cancer in 2012 were 4274, with 4133 deaths; survival rate at 5 years goes from 1% to 15%. Less than 20% of cases were considered resectable at the time of diagnosis. The Whipple procedure is currently the only curative treatment option for periampullary cancers since the first communication by Whipple in 1935, and up until now is a common procedure in several reference centres around the world. In 1994, Gagner reported the first totally laparoscopic pancreaticoduodenectomy. Some groups have currently demonstrated the safety and efficacy of this technique. Objective To report our initial experience with totally laparoscopic pancreaticoduodenectomy in the Hospital General de Mexico. Clinical case The case concerns a 58 year-old women with jaundice and loss of weight of 3 months onset. Her biopsy reported adenocarcinoma of Vater's ampulla, and as it was considered resectable, she underwent a laparoscopic pancreaticoduodenectomy. Conclusions This procedure must be performed in centres with experience in open pancreatic surgery and training in advanced laparoscopic surgery. The main advantages are lower blood loss and shorter hospital stay.