Objective To explore the clinical value of anterior "vein-first" approach during laparoscopicpancreaticoduodenectomy.Methods A retrospective study was reviewed for clinical data of 41 patients undergoing laparoscopic pancreaticoduodenectomy at Qingdao Municipal Hospital.Results All operations were successfully completed without any conversion into laparotomy. Two cases (4.9%) had right ectopic hepatic artery derived from superior mesenteric artery. Average operative duration was (5.1±2.4) h, average intraoperative bleeding (100±155) mL and average number of harvested lymph nodes (8.5±3.4). R0 resection was obtained in all malignant cases and postoperative hospital stay was (12.6±8.7) days. Postoperative complications included biochemical leakage (n=10, 24.4%), grade B pancreatic leakage (n=7, 17.1%), grade C pancreatic leakage (n=1, 2.4%), abdominal hemorrhage (n=3, 7.3%), bile leakage (n=4, 9.8%), postoperative gastric emptying disorder (n=3, 7.3%), abdominal infection (n=2, 4.9%) and death within 30 days (n=1, 2.4%).Conclusion Anterior "vein-first" approach technique is both simple and efficacious during laparoscopic pancreaticoduodenectomy. It is of great significance to reduce intraoperative hemorrhage and shorten operative duration. A wider popularization is worthwhile.
Key words
Laparoscopic pancreaticoduodenectomy /
Anterior approach /
Vein-first
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References
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