हेपेटोलॉजी और अग्नाशय विज्ञान

Laparoscopic pancreatic surgery

Abstract

Ritu Khare

Pancreatic surgery is related to a comparatively high morbidity and mortality compared with other abdominal surgeries. this is often a results of the complex nature of the organ, the difficult access as a results of the retroperitoneal position and also the number of technically challenging anastomoses required. Nevertheless, the past 20 years have witnessed a gentle improvement in morbidity and a decrease in mortality achieved through alterations of technique (particularly regarding the pancreatic anastomoses) along with hormonal manipulation to decrease pancreatic secretions. Recently minimally invasive or laparoscopic pancreatic surgery is now being performed in specialized HPB units round the world with results resembling open surgery and lesser morbidity. While practically all pancreatic surgeries is done laparoscopically, the foremost common procedure performed may be a laparoscopic distal pancreatectomy, thanks to the more straightforward nature of the resection and therefore the lack of a pancreatic ductal anastomosis. Laparoscopic distal pancreatectomy is sometimes performed for tumors within the distal body and tail of thepancreas. Laparoscopic lateral pancreaticojejunostomy is additionally commonly finished patients with chronic pancreatitis with a dilated main epithelial duct. Laparoscopic pancreatoduodenectomy or Whipple???s procedure is additionally possible in experienced centers in selected group of patients with periampullary tumors. The results are equivalent or better than those related to a conventional approach. one among the areas where the minimally invasive approach has been found to be exceptionally useful is in patients with necrotizing pancreatitis who require necrosectomy. A laparoscopic approach for necrosectomy is far safer and carries far less morbidity that the standard open necrosectomy. The procedure may be done multiple times to clear the necrotic areas and drain the infection. this method has also been shown to cut back surgery related mortality during this group of patients. The talk will target the present evidence base for increasing the utilization of laparoscopic pancreatic resection and can highlights challenges and other aspects that has got to be considered before adapting to the present technique.