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Laparoscopic Pancreaticoduodenectomy

The world’s first laparoscopic pancreaticoduodenectomy (LPD) was performed in 1992, but there were only a few reports in China at the beginning of the 21st century. Due to the lack of equipment, techniques, long operation time and high incidence of complications, by 2008, all the laparoscopic pancreaticoduodenectomies were basically stopped in China.

In October 2010, the surgical team of Professor Peng Bing of West China Hospital successfully performed the first laparoscopic pancreatoduodenectomy in Sichuan province and in western China. In 2018, 169 cases of laparoscopic pancreatoduodenectomies (no perioperative death) were performed. Up to now, more than 570 cases have been completed in 8 years, including 75 more difficult cases of LPD with the major vascular resection and reconstruction. The 90-day postoperative mortality rate was 0.87% (The number was 1% in the Johns Hopkins Hospital, the best hospital of pancreatic surgery in the world). The median survival period of pancreatic cancer was 20 months, compared to that of abdominal surgery, but with smaller trauma, faster recovery and lower incidence of complications.

Meanwhile, the surgical team firstly proposed “Two-surgeons Model” for LPD in China. The surgery of LPD used to be performed by only one chief surgeon, but now, it was completed by  the two chief surgeons, one of them was the first assistant, which demands more for the assistants and the team. The most effective effect of the Two-surgeons Model is that it shortens the operation time from nine hours to three hours.

At present, there are only a few pancreatic centers with the ability to complete the LPD with the major vascular resection and reconstruction reconstructing in the world, In particular, the LPD with artificial vessels and autogenous vessels. The HBP Minimally Invasive Center of West China Hospital is one of them. So far, 75 LPDs with the major vascular resection and reconstruction have been completed and there was no death in 90 days after operations. In terms of the number of operations, the difficulty of the operation, and the quality of the operation, the team ranks first in the country, leading in the world.