Tips for laparoscopic pancreaticoduodenectomy

Laparoscopic pancreaticoduodenectomy (LPD) is one of the most complex procedures performed in laparoscopic abdominal surgery, and its practice is still limited to only a few selected centers. Surgeons need to be proficient in advanced laparoscopic techniques and have a thorough understanding of the advantages and disadvantages inherent to the laparoscopic approach. LPD can be divided into the following steps: division of the omentum and colon mobilization; division of the proximal bowel and gastroduodenal artery, and transection of the common bile duct; making a retropancreatic window; dissection of ligament of Treitz and division of the distal bowel; dissection of the uncinate process and superior mesenteric vessels; and reconstruction. In this article, we describe our conventional technique for LPD. Highlight Despite its advantages, laparoscopic pancreaticoduodenectomy remains limited to a few selected centers, due to its complexity and steep learning curve. In this technical view, Asbun and colleagues share their expertise and describe in detail their conventional technique for laparoscopic pancreaticoduodenectomy to facilitate the adoption of this procedure at other centers.