Background

Performing a single-port laparoscopic pancreatectomy is technically challenging. Single-port laparoscopic pancreaticoduodenectomy (SPLPD) is rarely reported in English literature.

Methods

Eighty-seven cases of laparoscopic pancreaticoduodenectomy (LPD) were performed by a single surgical team in the Department of Pancreatic Surgery, West China Hospital, Sichuan University between February 2020 and December 2020. Among these, 13 cases of LPD (group 1) were performed using a single-port device. Basing on the same inclusion and exclusion criteria, 68 cases of LPD performed using traditional 5-trocar were included as a control group (group 2). The patient’s demographic characteristics, intraoperative, and postoperative variables were prospectively collected and retrospectively analyzed.

Results

Five men and eight women were included in the SPLPD group. The median age of these patients was 57 years. The patients who underwent SPLPD required a longer operative time (332.7 ± 38.1 min vs. 305.8 ± 64.7 min; p = 0.03) than those in the LPD group. The estimated blood loss, conversion rate, blood transfusion rate, time to oral intake, postoperative hospital stays, and perioperative complications were comparable between the two groups. The short-term oncological outcomes, such as R0 rate and lymph node harvested, were comparable between the two groups. The 90-day mortality of all patients was zero.

Conclusions

SPLPD is a safe and feasible procedure for well-selected patients in an experienced minimally invasive pancreatic surgery team. SPLPD may provide several potential advantages, such as the requirement of fewer trocars, fewer abdominal complications, and reduced participation of assistants than conventional LPD.

中文翻译：

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单孔腹腔镜胰十二指肠切除术

背景

进行单孔腹腔镜胰腺切除术在技术上具有挑战性。英文文献中很少报道单孔腹腔镜胰十二指肠切除术 (SPLPD)。

方法

2020年2月至2020年12月，四川大学华西医院胰腺外科由一个手术团队完成87例腹腔镜胰十二指肠切除术（LPD），其中13例LPD（第1组）使用单端口设备。基于相同的纳入和排除标准，将 68 例使用传统 5 套管针进行的 LPD 纳入对照组（第 2 组）。前瞻性收集并回顾性分析患者的人口统计学特征、术中和术后变量。

结果

SPLPD 组包括五名男性和八名女性。这些患者的中位年龄为 57 岁。 与 LPD 组相比，接受 SPLPD 的患者需要更长的手术时间（332.7 ± 38.1 分钟对 305.8 ± 64.7 分钟；p = 0.03）。两组之间的估计失血量、转化率、输血率、进食时间、术后住院时间和围手术期并发症具有可比性。短期肿瘤学结果，如 R0 率和淋巴结收获，在两组之间具有可比性。所有患者的 90 天死亡率为零。

结论

对于经验丰富的微创胰腺手术团队中精心挑选的患者，SPLPD 是一种安全可行的手术。SPLPD 可以提供几个潜在的优势，例如比传统的 LPD 需要更少的套管针、更少的腹部并发症以及减少助手的参与。