Can we overcome surgical difficulties of laparoscopic panceaticoduodenectomy by improving our learning curve?

Akira Umemura, Hiroyuki Nitta, Takeshi Takahara, Yasushi Hasegawa, Akira Sasaki


Minimally invasive laparoscopic pancreatectomy is still a technically challenging procedure due to the anatomical location of the pancreas and surrounding major vasculature. Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex procedures in gastroenterological surgery, requiring extensive lymph node dissection and complex reconstructive anastomoses. Although Gagner and Pomp first reported about LPD in 1994, acceptance was slowed by the inherent technical limitations of advanced laparoscopic skills (1). Recently, global performance rates of LPD have increased; however, feasibility and safety of LPD remain controversial.