The Clinical Application Of Pancreatic Minimally Invasive Surgery In Treatment Of Pancreatic Carcinoma

Objective: To evaluate the feasibility, safety and efficacy of pancreatic minimallyinvasive surgery in treatment of pancreatic carcinoma. Indicate different operationsfor minimally invasive pancreatic surgery for pancreatic carcinoma, summarize thesurgical procedures and operational skills.Methods: From June2009to February2014, there were14patients underwentlaparoscopic radical resection of carcinoma of pancreatic body and tail;37patientsunderwent robot-assisted radical resection of pancreatic carcinoma, include13casesof pancreatoduodenectomy and24cases of distal pancreatectomy. We observe andcompare the data of operative procedure, post-operative recovery, follow up results ofthe two methods. Bring out a preliminary evaluation of two methods in the treatmentof pancreatic ductal adenocarcinoma, discuss their surgical indications, and give asummary of their surgical procedures and operating skills.Results:1of the14patients who underwent laparoscopic radical resection ofcarcinoma of pancreatic body and tail were converted to laparotomy because ofinvolvement of the surrounding organs;3of the37patients who underwentrobot-assisted radical resection of pancreatic carcinoma were converted to laparotomybecause of tumor invasion or difficult separation. Mean operative time of laparoscopicgroup was235.0±60.4min, mean blood loss was392.9±221.1ml, the average hospital stay was20.2±8.3days and50%incidence of postoperative complications, with thepancreatic fistula rate of42.5%. Mean operative time of robot-assisted laparoscopicgroup was265.4±160.5min, mean blood loss was351.1±335.1mL, the averagehospital stay was22.1±12.0days and40.5%incidence of postoperative complications,with the pancreatic fistula rate of35.1%, and1case of perioperative mortality. Thepostoperative follow-up showed that among the14patients in the laparoscopic group,8patients died because of tumor recurrence and metastasis, the other6patients livedwithout tumor recurrence; and among the36followed-up patients in therobot-assisted laparoscopic group,16patients died because of tumor recurrence andmetastasis,2patients had locally recurrence, the other18patients lived without tumorrecurrence.Conclusion: Minimally invasive surgery in treatment of pancreatic carcinoma is safeand feasible, it can reduce trauma, pain and accelerate postoperative recovery.Because of its advantages in terms such as tumor isolation, lymph node dissection,digestive tract reconstruction, robot-assisted laparoscopic system expands the scope ofminimally invasive treatment of pancreatic carcinoma.