%0 Journal Article
%T Duodenopancreatectom¨ªa totalmente laparosc¨®pica: Consideraciones t¨¦cnicas y aplicabilidad inicial en un centro de alto volumen de cirug¨ªa pancre¨¢tica
%A Mazza
%A Osear
%A S¨¢nchez Ciar¨ªa
%A Rodrigo
%A Bersano
%A Fernanda
%A Yazde
%A Leonardo
%A de Santiba£¿es
%A Eduardo
%A Pekolj
%A Juan
%J Revista argentina de cirug£¿-a
%D 2012
%I Scientific Electronic Library Online
%X background: pancreatoduodenectomy is the treatment of choice for periampullary tumors. the first laparoscopic whipple was performed by gagner in 1994. however, the extensi¨®n of the dissection, the need to perform m¨²ltiple anastomoses in reconstructive phase and the length of the procedure were the main reasons that discouraged surgeons. however in recent years the laparoscopic whipple procedure has emerged as a therapeutic alternative with encouraging results in selected patients. aim: present the initial experience with laparoscopic whipple procedure and the technical aspeets of the approach. setting: hepatobiliopancreatic surgery sector of the hospital italiano de buenos aires. design: prospective, observational. population: 28 patients undergoing whipple procedure between december 2010 and june 2011, eight ofthem were addressed by laparoscopy and they are the group that we analyzed. method: we analyzed patients approached laparoscopically with intent resection. operative time, intra and postoperative complications, length of stay, conversi¨®n rate, applicability of the approach and the mortality rate of laparoscopic and global pancreatoduodenectomy were the variables that we analyzed. results: mean operative time was 470 minutes. the conversi¨®n rate to open surgery was 25%, and the applicability of the approach was 28%. there were 33% major complications. the average length of stay was 8 days. conclusions: laparoscopic whipple procedure £¿san alternative laparoscopic technique feasible in selected patients carry periampullary tumors, the initial selection of patients has led to a population of more easily resectable disease, but more difficult to rebuild.
%K p¨¢ncreas
%K laparoscopic surgery.
%U http://www.scielo.org.ar/scielo.php?script=sci_abstract&pid=S2250-639X2012000200003&lng=en&nrm=iso&tlng=en