J.Jpn. Surg. Soc.. 123(5): 384-389, 2022

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Feature topic

EVIDENCE ON LAPAROSCOPIC PANCREATECTOMY

Laparoscopic surgery has emerged as an alternative to open surgery, and this approach has also been applied to pancreatectomy. Most clinical trials of laparoscopic pancreatectomy have been based on retrospective analysis, but in recent years, some randomized controlled trials (RCTs) have been reported. In Japan, a prospective preoperative registration survey of laparoscopic pancreatectomy showed that the short-term results of laparoscopic pancreatic resection were excellent. Regarding laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD), both LDP and LPD are recommended for pancreatic tumors including pancreatic cancer because they can improve the short-term outcomes and be equivalent to long-term outcomes compared with open surgery. Further accumulation of RCT results of short- and long-term outcomes for pancreatic cancer is mandatory. On the other hand, LPD has been reported to be associated with postoperative mortality and hospital case volume. In Japan as well, the short-term results of laparoscopic pancreatectomy have been better at experienced institutions. Laparoscopic pancreatectomy should be performed in institutions with accumulated experience.

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