Open, laparoscopic and robot-assisted surgery for periampullary cancer (outcomes, advantages, drawbacks)

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.