Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.
, Donatella Pisaniello 1, Alberto Piatto 1, Domenico Parmeggiani 1, Rossella Sperlongano 1, Nicola Avenia 2, Alfonso Barbarisi 3, Umberto Parmeggiani 11 Department of Aenesthesiological, Surgical and Emergency Sciences, Vth Unit of General Surgery and Advanced Surgical Techniques, Second University of Naples, Italy
2 Department of Head and Neck Surgery, Hospital of Terni, 3 IXth Unit of General Surgery and Biotechnology Applied to Surgery, Second University of Naples, Italy
Abstract
Carcinoma of the pancreas is extremely common, with a five-year mortality rate of about 95-99%. Radical surgery requires good technical skill and can cause complications and operative mortality, but should be avoided in patients with extrapancreatic involvement. Advances in dynamic spiral CT-scan have decreased the number of unnecessary laparotomies. VLS is indicated in cases of pancreatic mass deemed resectable or "doubtful" by CT-scan. Direct laparoscopic visualization can be combined with intraoperative laparoscopic ultrasonography (LUS), which has shown a positive predictive value of resectability of 91%. Laparoscopic pancreatoduodenectomy (LPD) shows a high rate of complications and should be performed by very well-trained surgeons. Laparoscopic distal pancreatectomy (LDP) with an "en bloc" splenectomy and spleen preservation should be performed.
Keywords
- Tumor
- Neoplasia
- Pancreas
- Laparoscopy
- Pancreatic Cancer