Pancreatoduodenectomía totalmente laparoscópica: Técnica quirúrgica y experiencia inicial*

Abstract Totally laparoscopic pancreaticoduodenectomy: Surgical technique and initialexperience Introduction: Nowadays the utility of laparoscopic pancreatic surgery is accepted for a wide varietyof indications. However pancreaticoduodenectomy has been considered beyond the possibilities oflaparoscopy by the majority of surgeons. The objective of this report is to show our surgical techniqueand initial experience with totally laparoscopic pancreaticoduodenectomy. Material and Methods: Betweennovember of 2007 and june of 2008, a laparoscopic technique was offered to patients with indication ofpancreaticoduodenectomy for different pathologies. We describe the surgical technique, perioperativecare, intraoperative complications, need for conversion to open technique, mortality, and early postoperativecomplications. Results: A total of three patients were subjected to laparoscopic pancreaticoduodenectomy.The surgical indication was an ampullar adenocarcinoma in a 52 years old woman, a pseudopapilar tumor ofthe pancreatic head in a 17 years old woman, and a duodenal gastrointestinal stromal tumor in a 63 yearsold man. There was no need for conversion to open technique. There was no mortality. The operative timeranged from 300 to 360 min. The first patient presented an upper gastrointestinal bleeding, from pancreaticanastomoses requiring surgical hemostasis. The last patient developed a self-limited biliary fistula, managedsuccessfully with drains. The hospital stay varied from 8 to 25 days.