췌두부 낭성종양에 대해 시행된 복강경 보조 유문보존 췌십이지장절제술

Abstract

Surgery on the pancreas is difficult with a laparoscopic approach due to its retroperitoneal location and proximity to major vessels, such as the hepatic artery and portal vein. For this reason, experiences of laparoscopic pancreatic surgery have been limited and moreover, only about 10 cases of laparoscopic pancreatoduodenectomy (PD) have been documented since its introduction by Gagner in 1994. Herein, we present 3 cases of laparoscopic assisted pylorus preserving pancreatoduodenectomy (PPPD) of cystic tumors located in the head of the pancreas. There was no mortality, but postoperative bleeding was associated with pancreatic fistula in two cases. Our initial experience demonstrates the technical feasibility of a laparoscopic PD. However, the risk of complications related to the complex reconstruction procedures, with the open method, still exists. To overcome this limitation and establish the safety of this procedure, further experiences along with new operative instruments and techniques will be required. (J Korean Surg Soc 2006;70: 486-490)