Minimally invasive pancreatic anastomosis after pancreaticoduodenectomy: multi-institutional step by step video description of the technique

Benedetto Ielpo*, Alessandro Anselmo, Yexin Koh, Fernando Burdio, Vito De Blasi, Patricia Sanchez-Velazquez, Juan Santiago Azagra, Cristiano Huscher, Antonio Giuliani, Gianluca Pellino, Edoardo Rosso

*Autor corresponent d’aquest treball

Producció científica: Contribució a una revistaArticleRecercaAvaluat per experts

2 Cites (Scopus)

Resum

Minimally invasive pancreaticoduodenectomy (PD) is attracting increased interest in the pancreatic surgical community with more and more teams reporting their experience worldwide. The pancreatic anastomosis (PA) is one of the key steps and challenging manoeuvre of this procedure. Since the introduction of the minimally invasive approach for PD, several PA types have been proposed, ranging from high to low complexity, but none of them have been proven unequivocally superior to the others. Therefore, definitive consensus has not been reached yet. In the present multimedia manuscript, we report the most commonly adopted minimally invasive PA and we propose a “complexity classification” to guide the choice accordingly to different characteristics of the pancreatic stump. We describe five possible different PA that might be tailored to each different case, depending mainly on texture of pancreatic stump (soft/hard, lean/fatty) and the size and visibility of main duct. This manuscript presents a step-by-step portfolio of the most commonly used mini-invasive PA. This technique requires experience in pancreatic surgery and advanced minimally invasive skills. Knowledge of and proficiency in different types of PA could help reducing the incidence of postoperative pancreatic fistula.
Idioma originalEnglish
Pàgines (de-a)255-259
Nombre de pàgines5
RevistaUpdates in Surgery
Volum75
Número1
DOIs
Estat de la publicacióPublicada - de gen. 2023

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