Journal of hepato-biliary-pancreatic sciences
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J Hepatobiliary Pancreat Sci · Mar 2011
Comparative StudyRobot-assisted laparoscopic pancreaticoduodenectomy.
Robotic surgery is the most advanced development in minimally invasive surgery. However, the number of reports on robot-assisted endoscopic gastrointestinal surgery is still very small. In this article, we describe total laparoscopic pancreaticoduodenectomy (PD) undertaken using the da Vinci Surgical System® (Intutive Surgical). ⋯ Robot-assisted PD required a long time, but organ removal with less bleeding was able to be safely performed owing to the high degree of freedom associated with the forceps manipulation and the magnified view. Similarly, pancreatojejunostomy could certainly be conducted. No major postoperative complications were found. Accumulation of da Vinci PD experience in the future will lead to safer and faster PD.
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J Hepatobiliary Pancreat Sci · Jan 2011
Case ReportsLaparoscopic hepatic left lateral sectionectomy using the LaparoEndoscopic Single Site approach: evolution of minimally invasive liver surgery.
Laparoscopic liver surgery is attracting wider interest for the treatment of benign and malignant neoplasms. Laparoscopy is a safe and feasible approach for lesions located in the left liver lobe. As the emphasis on minimizing the technique continues, single-port access surgery is quickly evolving. We present our initial experience of single-port laparoscopic liver surgery using a LaparoEndoscopic Single Site (LESS) approach with the TriPort System (ASC; Advanced Surgical Concepts, Bray, Ireland) to perform a left lateral sectionectomy via a single supraumbilical incision. ⋯ Single-port laparoscopic left lateral sectionectomy is a feasible procedure, when performed by experienced laparoscopic surgeons. It has to be determined whether or not this approach would offer benefit to patients, except in terms of cosmesis, compared to standard laparoscopic liver resection.
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J Hepatobiliary Pancreat Sci · Jan 2011
Biliary reconstruction with wide-interval interrupted suture to prevent biliary complications in pediatric living-donor liver transplantation.
Liver transplantation is an established therapy for children with end-stage chronic liver disease or acute liver failure. However, despite refinements of surgical techniques for liver transplantation, the incidence of biliary tract complications has remained high in recent years. Therefore, we suggest our anastomotic technique with wide-interval interrupted suture to prevent biliary complications in pediatric living-donor liver transplantation (LDLT). ⋯ Biliary reconstruction with wide-interval interrupted suture prevents anastomotic strictures and bile leakage in pediatric LDLT.
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J Hepatobiliary Pancreat Sci · Nov 2010
Multicenter Study Comparative StudyInferior head resection of the pancreas for intraductal papillary mucinous neoplasms.
Previous reports have suggested that patients with intraductal papillary mucinous neoplasm (IPMN) have a favorable prognosis after surgical resection. Thus, a variety of types of partial pancreatic resections have been advocated for treating these low-grade malignant tumors. However, the surgical outcome of IPMN after such limited pancreatectomy has not been fully clarified. ⋯ Pancreatic endocrine and exocrine function was well preserved after inferior head resection. Pancreatic fistula occurred more frequently after inferior head resection than with conventional pancreatoduodenectomy. Patients with noninvasive IPMN had favorable survivals after this procedure. However, one patient with minimally invasive IPMN with margin-positive R1 resection died of recurrent disease. Thus, margin-negative R0 resection should be performed for IPMN.
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J Hepatobiliary Pancreat Sci · Sep 2010
Review Meta AnalysisIntraperitoneal use of local anesthetic in laparoscopic cholecystectomy: systematic review and metaanalysis of randomized controlled trials.
With the advent of minimally invasive gallbladder surgery, and now with natural orifice techniques emerging, visceral nociception has been neglected as a cause of postoperative pain. A systematic review and metaanalysis was carried out to investigate the use of intraperitoneal local anesthetic (IPLA) in order to assess its role in laparoscopic cholecystectomy (LC). The aim of this systematic review was to appraise the clinical effects of this modality. ⋯ There is evidence in favor of IPLA in LC. Further trials of this modality in LC are not needed as these are unlikely to reduce clinical heterogeneity. IPLA should be trialled as future minimally invasive surgical techniques approach.