ABSTRACT

Although the rapid development in laparoscopic surgery, pancreaticoduodenectomy (PD) is still one of the most discussed and technically demanding surgery performed only at few centers in the world. This report describes a total laparoscopic pylorus-preserving PD for a tumor of ampulla of Vater with a successful outcome, representing the first description of this laparoscopic procedure in Turkey. The patient was a 58-year-old male patient with the diagnosis of ampullary tumor. The operation was performed with 5 ports. Following resection, all anastomoses were made intracorporeally. A double layer pancreaticogastrostomy, an end-to-side choledocho-jejunostomy, a two layer duodeno-jejunustomy and drain placements completed the operation. The operating time was 510 minutes, and estimated blood loss was 350 ml. Surgical margins were negative and number of retrieved lymph nodes was 14. The patient was discharged on postoperative day 7 without complication. This case demonstrates that laparoscopic PD is a feasible operative procedure in carefully selected patients. This technique can achieve adequate margins and follow oncological principles. However randomized comparative studies are needed to establish the superiority of minimal invasive surgery over traditional open surgery.