Topic Highlight Open Access
Copyright ©2014 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2014; 20(39): 14255-14262
Published online Oct 21, 2014. doi: 10.3748/wjg.v20.i39.14255
Laparoscopic resection of pancreatic adenocarcinoma: Dream or reality?
Blaire Anderson, Shahzeer Karmali, Department of Surgery, University of Alberta, Edmonton, Alberta T6G 2B7, Canada
Shahzeer Karmali, Center for the Advancement of Minimally Invasive Surgery, Royal Alexandra Hospital, Edmonton, Alberta T5H 3V9, Canada
Author contributions: Anderson B reviewed the literature and wrote the paper; Karmali S supervised the review.
Correspondence to: Shahzeer Karmali, BSc, MD, MPH, Assistant Professor, Surgical Director, Weight Wise Bariatric Surgery, Minimally Invasive Gastrointestinal and Bariatric Surgery, Center for the Advancement of Minimally Invasive Surgery, Royal Alexandra Hospital, Room 405 Community Services Center, 10240 Kingsway, Edmonton, Alberta T5H 3V9, Canada. shahzeer@ualberta.ca
Telephone: +1-780-7356650 Fax: +1-780-7356652
Received: November 28, 2013
Revised: January 27, 2014
Accepted: May 29, 2014
Published online: October 21, 2014

Abstract

Laparoscopic pancreatic surgery is in its infancy despite initial procedures reported two decades ago. Both laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreaticoduodenectomy (LPD) can be performed competently; however when minimally invasive surgical (MIS) approaches are implemented the indication is often benign or low-grade malignant pathologies. Nonetheless, LDP and LPD afford improved perioperative outcomes, similar to those observed when MIS is utilized for other purposes. This includes decreased blood loss, shorter length of hospital stay, reduced post-operative pain, and expedited time to functional recovery. What then is its role for resection of pancreatic adenocarcinoma? The biology of this aggressive cancer and the inherent challenge of pancreatic surgery have slowed MIS progress in this field. In general, the overall quality of evidence is low with a lack of randomized control trials, a preponderance of uncontrolled series, short follow-up intervals, and small sample sizes in the studies available. Available evidence compiles heterogeneous pathologic diagnoses and is limited by case-by-case follow-up, which makes extrapolation of results difficult. Nonetheless, short-term surrogate markers of oncologic success, such as margin status and lymph node harvest, are comparable to open procedures. Unfortunately disease recurrence and long-term survival data are lacking. In this review we explore the evidence available regarding laparoscopic resection of pancreatic adenocarcinoma, a promising approach for future widespread application.

Key Words: Laparoscopic surgery, Pancreatic cancer, Laparoscopic distal pancreatectomy, Laparoscopic pancreaticoduodenectomy, Adenocarcinoma

Core tip: Laparoscopic pancreatic surgery is in its infancy despite initial procedures reported two decades ago. Both laparoscopic distal pancreatectomy and laparoscopic pancreaticoduodenectomy can be performed competently with improved perioperative outcomes, similar to those observed when minimally invasive surgical (MIS) is utilized for other purposes. However, when MIS approaches are implemented the indication is often benign or low-grade malignant pathologies. In this review we explore the evidence available regarding laparoscopic resection of pancreatic adenocarcinoma, a promising approach for future widespread application.



INTRODUCTION

In 2013 an estimated 45220 new cases of pancreatic cancer will be diagnosed in the United States resulting in approximately 28460 deaths[1]. Pancreatic adenocarcinoma is one of the most aggressive malignant tumors. Overall, prognosis is dismal with recent 5-year survival estimates merely 6%[1]. Oncologic surgical resection is the only potentially curative treatment[2,3]. Unfortunately only 15%-20% of patients have resectable disease at presentation[4]. This is secondary to rapid local spread, invasion of critical surrounding structures, and early distant metastases. Surgical options are as follows; pancreatic body and tail tumors can be resected by subtotal or distal pancreatectomy (DP), while pancreatic head tumors are amendable to pancreaticoduodenectomy (PD).

LAPAROSCOPIC PANCREATIC SURGERY

Laparoscopic pancreatic surgery has been slow to evolve, primarily reserved for staging and palliation[5-9] despite the performance of initial minimally invasive surgical (MIS) pancreatic procedures two decades ago[10-12]. This delay can likely be attributed to multiple factors, including the retroperitoneal location of the pancreas, anatomic complexity of surrounding structures, friable nature of the gland, and propensity for post-operative complications. To date laparoscopic procedures currently executed include: (1) diagnostic laparoscopy with or without biopsy; (2) palliative interventions including gastro- and hepatico-jejunostomy; (3) DP with or without splenectomy; (4) PD; (5) tumor enucleation; and (6) central pancreatectomy. Feasibility is well established[13-16]; however by no means are MIS techniques mainstream and when utilized reserved for benign and low-grade malignant tumors.

LAPAROSCOPIC SURGERY FOR PANCREATIC ADENOCARCINOMA

The results of the Clinical Outcomes of Surgical Therapy trial have promoted the implementation of MIS techniques in the treatment of colon cancer with equivalent recurrence and overall survival rates[17]. As well, further studies have demonstrated oncologic outcomes in MIS resection of other abdominal malignancies to be equivalent to open techniques[18-22]. MIS approaches offer the added benefits of decreased blood loss, shorter length of hospital stay, reduced post-operative pain, and expedited time to functional recovery. These improved perioperative outcomes are of paramount importance in regards to pancreatic adenocarcinoma, where improved recovery can mean earlier instigation of adjuvant treatment. Skepticism persists surrounding oncologically sound surgical resection, crucial in any malignancy. Additionally, due to tumor biology and aggressiveness of disease process pancreatic resections for adenocarcinoma are not commonly performed making it difficult to overcome the associated learning curve. Long-term survival data is scarce leaving evidence reliant on short-term surrogate markers including margin status and lymph node retrieval. In general, lack of quality data has hindered MIS progress for pancreatic malignancies.

LAPAROSCOPIC DISTAL PANCREATECTOMY

Laparoscopic approaches to DP improve visualization of the retroperitoneal pancreas and minimize incisional trauma. This procedure is amendable to MIS techniques, as it requires limited dissection and no anastamoses. However, pancreatic stump management and the prevention of fistulae prove trying. Variations exist in the utilizations of hand-access approaches, which provide the benefit of improved tactile feedback, and splenic preservation, which has been reported to reduce postoperative and overall infectious complications[23]. Overall, cosmesis, reduced blood loss, shorter length of hospital stay, less post-operative pain, and expedited time to functional recovery results from laparoscopic distal pancreatectomy (LDP)[14,24-33]. Additionally, in a Canadian study, Fox et al[34] demonstrated equal surgical costs, decreased length of stay, and decreased overall costs ($10842 vs $13656 for LDP and ODP respectively). Long-term oncologic outcomes have yet to be reported; however R0 resection and lymph node harvest are comparable to open resections (Table 1)[35-47].

Table 1 Published comparisons of laparoscopic distal pancreatectomy and open distal pancreatectomy with at least five cases of adenocarcinoma.
StudyCases
Malignant pathology
Mean node harvest
R0 margins
Mean blood loss (mL)
Mean length of stay (d)
Pancreatic fistula rate
Mortality
Overall morbidity
LDPODPLDPODPLDPODPLDPODPLDPODPLDPODPLDPODPLDPODPLDPODP
Rehman et al[35]814100%100%16114188%86%30665081225%21%0%0%NRNR
Mehta et al[36]303023%23814NRNR29472691317%13%0%3%50%43%
Limongelli et al[37]162936%45%NRNR94%93%1603656918%20%0%3%25%41%
Abu Hilal et al[38]351619%11%NRNR75%67%20039471129%44%0%6%40%69%
DiNorcia et al[39]7116813%39%6897%87%1509005611%14%0%1%28%44%
Vijan et al[40]10010023%23%NRNR0%01715196917%17%3%1%34%29%
Kooby et al[41]23189100%100%141273%74%422790711NRNR0%1%NRNR
Jayaraman et al[42]10723617%47%6797%96%1753005615%13%0%1%26%33%
Baker et al[43]278529%30%59NRNR2196124822%14%0%2%37%35%
Finan et al[44]449825%42%NRNR0%0%1577196950%46%0%5%NRNR
Kooby et al[45]14220036%49%NRNR92%93%3575886911%18%0%1%40%57%
Eom et al[46]316210%7%NRNRNRNRNRNR121410%7%0%0%36%24%
Velanovich[47]151520%32%NRNRNRNRNRNR5813%13%0%0%20%27%
Pancreatic fistulae

In several large case control series morbidity has proven to be comparable to open approaches (Tables 1 and 2). The potentially devastating nature of complications associated with pancreatic fistula has led to great debate regarding the optimal management of the pancreatic stump[48]. Techniques currently utilized include staple closure with or without staple line reinforcement, electrocautery, ultrasound coagulation, radiofrequency, omental patch, fibrin glue, enteric anastamosis, occtreotide administration, or a combination[49-55]. There has yet to be a consensus on the best method for stump management, even in the literature for open procedures[55]. Kooby et al[45] reported fistula rates to be similar between LDP and ODP (26% vs 32%, P = 0.28). In this study linear stapler was utilized for pancreatic transaction. Topical sealants and perioperative octreotide were added at the discretion of the treating surgeon. With MIS approaches providing comparable results in terms of pancreatic fistula rates, this should not deter laparoscopic advancement.

Table 2 Definitions of post-operative pancreatic fistulae.
StudyDefinition of post-operative pancreatic fistula
Rehman et al[35]ISGPF definition
Mehta et al[36]ISGPF (grade B and C)
Limongelli et al[37]ISGPF definition
Abu Hilal et al[38]ISGPF definition
DiNorcia et al[39]ISGPF definition
Vijan et al[40]ISGPF definition
Kooby et al[41]NR
Jayaraman et al[42]ISGPF definition
Baker et al[43]ISGPF definition
Finan et al[44]ISGPF definition
Kooby et al[45]ISGPF definition
Eom et al[46]Drainage > 30 mL with amylase > 600 U/dL
Velanovich[47]Amylase-rich fluid after POD 3
Splenic preservation

MIS approaches lead to greater splenic preservation[26,45,56]; however, in the case of malignancy, proximity of tumor to splenic vasculature often makes preservation difficult while achieving oncologic resection. The Warshaw technique, in which splenic vessels are resected en bloc, leaves the spleen to survive on the short gastric and left gastroepiploic vessels; providing an alternative more oncologically appropriate approach[57]. Complications associated with this method include gastric variceal hemorrhage and splenic infarction. Ferrone et al[58] in a retrospective review of 721 patients who underwent open distal pancreatectomy, 158 of who had a Warshaw spleen preserving distal pancreatectomy, reported evidence of perigastric varices in 25% of patients on follow-up computed tomography scan. Perhaps a paraphysiologic finding, as no clinically relevant adverse events were observed at up to 21 years follow-up. Re-operation, splenectomy, for splenic infarction was required in only 3 cases. From this, it was postulated that splenic preservation using the Warshaw technique should be considered in patients undergoing distal pancreatectomy for nonmalignant pathologies. Only 6% of this study population had pancreatic adenocarcinoma leaving reservations in the extrapolation of results to this subgroup. Similar findings have been published in laparoscopic series[25,59-63]. Jean-Philippe Adam et al[64] reviewed a cohort of 154 patients who underwent LDP with splenic preservation. Again, the indication for operation was benign or low-grade malignant tumors. Overall morbidity, pancreatic fistula, and reoperation were similar regardless of technique. Splenic preservation was less successful with the Warshaw technique compared with splenic vessel preservation, 84.7% vs 96.4% respectively (P = 0.03). Nine patients in the Warshaw group presented to hospital with symptomatic post-operative splenic infarction, necessitating splenectomy in four. Greater splenic preservation without compromised oncologic resection is favorable and achievable with laparoscopic approaches.

Oncologic outcomes

Potential for cure in this disease process is approached with R0 resection, therefore margin status is of paramount importance[65]. Another short-term surrogate measure of oncologic outcome is lymph node harvest. Venkat’s[24] recent systematic review and meta-analysis reported no significant difference between R0 resection in LDP, 95.5%, and ODP, 91.2% (P = 0.27). Meta-analysis was not completed for lymph node harvest due to inadequately reported data. A retrospective cohort study by Jayaraman et al[42] compared 343 patients. The laparoscopic group had fewer cancer cases (17% vs 47%, P < 0.0001); however oncologic outcomes including R0 negative margins (97% vs 96%, P = 0.76) and lymph node harvest (6 vs 7, P = 0.53) were equivalent. Subsequently, Kooby et al[41] in a multicenter analysis of LDP (11%) vs ODP (89%) for adenocarcinoma, which included 212 patients, published similar results for R0 resection (27% vs 26% positive margins, P = 0.98) and lymph node harvest (12.5 ± 8.5 vs 13.8 ± 8.4 nodes, P = 0.47). DiNorcia et al[39] retrospective cohort study of 360 patients reported lymph node yield (6 LDP vs 8 ODP, P = 0.29); however more successful R0 resection in the LDP group with 2.8% positive margins compared to 13% in the ODP group (P = 0.01). Song et al[62] presented results of a 359 patients case series, 6.7% with adenocarcinoma. They achieved a 91% R0 resection and mean lymph node harvest of 10.3 ± 8.6 with overall survival rates of 85.2% at up to 2 years follow-up. Contrarily, Baker et al[43] in a retrospective cohort study of 112 patients reported a “less robust lymphadenectomy” with 5 compared to 9 nodes harvested with the open approach (P = 0.04). Again, in this cohort study adenocarcinoma was more commonly found on final pathology in the open group (21% vs 4%). Perhaps this difference partially explains the observed results. Unfortunately, margin status was not reported.

LAPAROSCOPIC PANCREATICODUODENECTOMY

Approaching PD laparoscopically is more complex owing to the intricacy of dissection and reconstruction as well as the necessity of multiple critical anastomoses. None-the-less feasibility has been demonstrated[66-70]. The use of a mini-laparotomy and hand-port for creation of the anastomoses is helpful[67,71-75]. MIS approaches are promising, with lower rates of delayed gastric emptying and wound infection when compared to historic open PD controls[16]. Asbun and Stauffer[76] unmatched comparative trial of patients undergoing laparoscopic pancreaticoduodenectomy (LPD) (n = 53) and OPD (n = 215) demonstrated advantages for LPD in terms of blood loss (103 mL vs 195 mL, P < 0.001), transfusion requirement (4.7 units vs 0.6 units, P < 0.001), length of intensive care unit stay (3 d vs 1 d, P < 0.001), and total hospital stay (12 d vs 8 d, P < 0.001). Again, long-term oncologic outcomes have yet to be reported[76]; however R0 resection and lymph node harvest seem sufficient (Table 3)[15,67,69,72,75-85]. It is clear that higher levels of evidence including controlled trials are needed to elucidate clear conclusions.

Table 3 Published series on laparoscopic and robotic pancreaticoduodenectomy with at least five cases of adenocarcinoma (variables reported for entire series, not just malignant cases).
StudyCasesMalignant pathologyMean node harvest (range)R0 marginMean blood loss (mL)Mean length of stay (d)Pancreatic fistula rateMortalityOverall morbidityMean operative time (min)
2Bao et al[77]284 AC15 (8-32)163%10017 121%7%NR4311
10 PDAC
Kim et al[78]1004 AMP13 (7-34)100%NR146%1%25%487
7 PDAC
Asbun et al[76]538 AMP23 (SD 10)95%195817%6%22%608
22 PDAC
2Chalikonda et al[79]3014 adeno-carcinoma13 (1-37)100%486107%3%30%476
2Lai et al[80]205 AC10 (SD 60)73%2471435%0%50%492
7 PC
2Zeh et al[81]509 AMP17 (5-37)89%35011020%2%30%35681
14 PDAC
Suzuki et al[72]64 AMP18 (16-27)100%471123133%0%33%5811
1 PDAC
Ammori et al[15]72 AMP20.8 (11-32)NR3501114%0%29%628
5 PDAC
2Giulianotti et al[82]6015 AMP18 (5-45)92%3942231%14%31%421
27 PDAC
Kendrick et al[83]628 AMP15 (6-31)89%240718%2%42%3681
31 PDAC
Cho et al[66]151 AMP19 (NR)100%4451613%0%27%338
4 PDAC
Palanivelu et al[84]7529 AMP14 (8-22)97%7487%1%27%357
33 PDAC
Pugliese et al[67]194 AMP12 (4-22)100%1801823%0%37%461
6 PDAC
Dulucq et al[75]254 AMP18 (NR)100%107165%5%32%287
11 PDAC
Staudacher et al[69]71 PDAC26 (16-47)100%325120%0%0%416
Gagner et al[85]103 AMP7 (3-14)100%NR2217%0%50%510
4 PDAC
Resource allocation

In the absence of definitive clinical improvements, feasibility with no poorer results may not justify LPD in light of prolonged operative times, with initial case reports taking upwards of 750 min to completion[10,86]. The learning curve can be overcome in high volume centers, with average operative times decreased to less than 400 min, similar to open PDs (Table 3). Kendrick and Cusati[83], in one of the largest single series available, describe their initial duration of LPD to be 7.7 h, which improved to 5.3 h after approximately 50 cases. Time is money. Mesleh et al[87] in an American cost-analysis study comparing open and LPD at a single institution proclaimed that LDP was associated with equivalent overall costs compared with open PD. In their study, operating time and supply costs were higher for LPD; however post-operative admission was more cost-effective. Neither operative time nor cost should be detrimental to further application of novel MIS approaches in pancreatic surgery.

Oncologic outcomes

PD is mainly utilized for malignant rather than benign disease therefore oncologic safety must be demonstrated prior to widespread application. Gumbs et al[16] published a large review that incorporated 27 published papers for a total of 285 cases, of which 32% were adenocarcinoma. Cumulatively, the mean number of lymph nodes harvested ranged from 7 to 36 with a weighted average of 15 nodes. Of the reported margins (174) only 0.4% were positive. Perioperative morbidity and mortality rates were similar compared to open PDs. The study of Kendrick and Cusati[83], described earlier, which included 65 patients who underwent total LPD, 48% for pancreatic adenocarcinoma and 12% for ampullary adenocarcinoma, published outcomes comparable to the open approach. Their study demonstrated an 89% R0 resection with an average of 15 lymph nodes harvested (range 6-31). Recently, 2-year survival rates of 43% and 36% were reported for LDP and OPD respectively[88]. Dulucq et al[75] performed a prospective case series of 25 patients, 44% with pancreatic adenocarcinoma and 12% with ampullary adenocarcinoma. They demonstrated a 100% R0 resection with an average lymph node retrieval of 18 ± 5. Gumbs and Gayete[89] found similar results in their experience with the posterior approach, laparoscopic duodenopancreatectomy, retrieving an average of 16 lymph nodes. Unfortunately, resection margins were not reported. Results are encouraging.

A WORD ON ROBOTICS

Robotic-assisted procedures are of interest in pancreatic resection as theoretically they add increased maneuverability, provide precise tissue manipulation, and improve visualization in three dimensions. Disadvantages include loss of tactile feedback, equipment setup and maintenance issues, increased operative times, and associated learning curve. Several studies have presented promising results for robotically assisted DP, with operative morbidity and mortality comparable to other techniques[90-95]. Similarly, supportive evidence exists for combined laparoscopic-robotic and purely robotic PD procedures[95-102]. Additionally, cost does not appear to be as much of a factor as was initially perceived. An American study by Waters et al[91] confirmed cost effectiveness for robotic DP. The total cost of robotic DP was $10588, compared to $16059 and $12986 for ODP and LDP respectively. Boggi et al[97] reported costs of robotic PD to be an additional 6193 Euros compared to OPD. Yet in its infancy, enthusiasm should not be dampened for robotic pancreatic surgery, as preliminary results are praiseworthy.

CONCLUSION

Current evidence suggests that laparoscopic pancreatic surgery is feasible and provides benefits over open surgery including decreased blood loss, shorter length of stay, reduced post-operative pain, and expedited time to functional recovery. However, the implementation of MIS approaches to pancreatic adenocarcinoma is limited compared to open approaches. The technical complexity and lack of resectable cases necessary to overcome steep learning curves partly explains the limited utilization by surgeons. Concerns regarding oncologic outcomes may also be implicated. Data on long-term outcomes of tumor recurrence and patient survival are not well defined and ultimately, the success of oncologic operations depends on cancer related long-term survival. Currently laparoscopic pancreatic surgery remains a reasonable surgical option for benign disease and low-grade malignant tumors when performed by expert surgeons in high volume specialty centers. In the future, perhaps after oncologic safety has been well demonstrated, MIS techniques can be recommended for pancreatic adenocarcinoma, as early results are promising.

Footnotes

P- Reviewer: Clark CJ, Wang SE S- Editor: Gou SX L- Editor: A E- Editor: Liu XM

References
1.  Siegel R, Naishadham D, Jemal A. Cancer statistics, 2013. CA Cancer J Clin. 2013;63:11-30.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 9215]  [Cited by in F6Publishing: 9710]  [Article Influence: 882.7]  [Reference Citation Analysis (3)]
2.  Wagner M, Redaelli C, Lietz M, Seiler CA, Friess H, Büchler MW. Curative resection is the single most important factor determining outcome in patients with pancreatic adenocarcinoma. Br J Surg. 2004;91:586-594.  [PubMed]  [DOI]  [Cited in This Article: ]
3.  Butturini G, Stocken DD, Wente MN, Jeekel H, Klinkenbijl JH, Bakkevold KE, Takada T, Amano H, Dervenis C, Bassi C. Influence of resection margins and treatment on survival in patients with pancreatic cancer: meta-analysis of randomized controlled trials. Arch Surg. 2008;143:75-83; discussion 83.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 225]  [Cited by in F6Publishing: 233]  [Article Influence: 14.6]  [Reference Citation Analysis (0)]
4.  Bilimoria KY, Bentrem DJ, Ko CY, Stewart AK, Winchester DP, Talamonti MS. National failure to operate on early stage pancreatic cancer. Ann Surg. 2007;246:173-180.  [PubMed]  [DOI]  [Cited in This Article: ]
5.  Pisters PW, Lee JE, Vauthey JN, Charnsangavej C, Evans DB. Laparoscopy in the staging of pancreatic cancer. Br J Surg. 2001;88:325-337.  [PubMed]  [DOI]  [Cited in This Article: ]
6.  Ahmed SI, Bochkarev V, Oleynikov D, Sasson AR. Patients with pancreatic adenocarcinoma benefit from staging laparoscopy. J Laparoendosc Adv Surg Tech A. 2006;16:458-463.  [PubMed]  [DOI]  [Cited in This Article: ]
7.  Camacho D, Reichenbach D, Duerr GD, Venema TL, Sweeney JF, Fisher WE. Value of laparoscopy in the staging of pancreatic cancer. JOP. 2005;6:552-561.  [PubMed]  [DOI]  [Cited in This Article: ]
8.  Mori T, Abe N, Sugiyama M, Atomi Y, Way LW. Laparoscopic pancreatic cystgastrostomy. J Hepatobiliary Pancreat Surg. 2000;7:28-34.  [PubMed]  [DOI]  [Cited in This Article: ]
9.  Röthlin MA, Schöb O, Weber M. Laparoscopic gastro- and hepaticojejunostomy for palliation of pancreatic cancer: a case controlled study. Surg Endosc. 1999;13:1065-1069.  [PubMed]  [DOI]  [Cited in This Article: ]
10.  Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy. Surg Endosc. 1994;8:408-410.  [PubMed]  [DOI]  [Cited in This Article: ]
11.  Gagner M, Pomp A, Herrera MF. Early experience with laparoscopic resections of islet cell tumors. Surgery. 1996;120:1051-1054.  [PubMed]  [DOI]  [Cited in This Article: ]
12.  Sussman LA, Christie R, Whittle DE. Laparoscopic excision of distal pancreas including insulinoma. Aust N Z J Surg. 1996;66:414-416.  [PubMed]  [DOI]  [Cited in This Article: ]
13.  Gagner M, Palermo M. Laparoscopic Whipple procedure: review of the literature. J Hepatobiliary Pancreat Surg. 2009;16:726-730.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 92]  [Cited by in F6Publishing: 80]  [Article Influence: 5.3]  [Reference Citation Analysis (0)]
14.  Briggs CD, Mann CD, Irving GR, Neal CP, Peterson M, Cameron IC, Berry DP. Systematic review of minimally invasive pancreatic resection. J Gastrointest Surg. 2009;13:1129-1137.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 98]  [Cited by in F6Publishing: 109]  [Article Influence: 7.3]  [Reference Citation Analysis (0)]
15.  Ammori BJ, Ayiomamitis GD. Laparoscopic pancreaticoduodenectomy and distal pancreatectomy: a UK experience and a systematic review of the literature. Surg Endosc. 2011;25:2084-2099.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 76]  [Cited by in F6Publishing: 84]  [Article Influence: 6.5]  [Reference Citation Analysis (0)]
16.  Gumbs AA, Rodriguez Rivera AM, Milone L, Hoffman JP. Laparoscopic pancreatoduodenectomy: a review of 285 published cases. Ann Surg Oncol. 2011;18:1335-1341.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 82]  [Cited by in F6Publishing: 99]  [Article Influence: 7.6]  [Reference Citation Analysis (0)]
17.  Clinical Outcomes of Surgical Therapy Study Group. A comparison of laparoscopically assisted and open colectomy for colon cancer. N Engl J Med. 2004;350:2050-2059.  [PubMed]  [DOI]  [Cited in This Article: ]
18.  Zheng MH, Feng B, Lu AG, Li JW, Wang ML, Mao ZH, Hu YY, Dong F, Hu WG, Li DH. Laparoscopic versus open right hemicolectomy with curative intent for colon carcinoma. World J Gastroenterol. 2005;11:323-326.  [PubMed]  [DOI]  [Cited in This Article: ]
19.  Uyama I, Suda K, Satoh S. Laparoscopic surgery for advanced gastric cancer: current status and future perspectives. J Gastric Cancer. 2013;13:19-25.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 59]  [Cited by in F6Publishing: 66]  [Article Influence: 6.0]  [Reference Citation Analysis (0)]
20.  Kitano S, Shiraishi N. Current status of laparoscopic gastrectomy for cancer in Japan. Surg Endosc. 2004;18:182-185.  [PubMed]  [DOI]  [Cited in This Article: ]
21.  Lane BR, Campbell SC, Gill IS. 10-year oncologic outcomes after laparoscopic and open partial nephrectomy. J Urol. 2013;190:44-49.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 115]  [Cited by in F6Publishing: 118]  [Article Influence: 10.7]  [Reference Citation Analysis (0)]
22.  Heuer R, Gill IS, Guazzoni G, Kirkali Z, Marberger M, Richie JP, de la Rosette JJ. A critical analysis of the actual role of minimally invasive surgery and active surveillance for kidney cancer. Eur Urol. 2010;57:223-232.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 112]  [Cited by in F6Publishing: 125]  [Article Influence: 8.3]  [Reference Citation Analysis (0)]
23.  Shoup M, Brennan MF, McWhite K, Leung DH, Klimstra D, Conlon KC. The value of splenic preservation with distal pancreatectomy. Arch Surg. 2002;137:164-168.  [PubMed]  [DOI]  [Cited in This Article: ]
24.  Venkat R, Edil BH, Schulick RD, Lidor AO, Makary MA, Wolfgang CL. Laparoscopic distal pancreatectomy is associated with significantly less overall morbidity compared to the open technique: a systematic review and meta-analysis. Ann Surg. 2012;255:1048-1059.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 374]  [Cited by in F6Publishing: 366]  [Article Influence: 30.5]  [Reference Citation Analysis (0)]
25.  Melotti G, Butturini G, Piccoli M, Casetti L, Bassi C, Mullineris B, Lazzaretti MG, Pederzoli P. Laparoscopic distal pancreatectomy: results on a consecutive series of 58 patients. Ann Surg. 2007;246:77-82.  [PubMed]  [DOI]  [Cited in This Article: ]
26.  Jin T, Altaf K, Xiong JJ, Huang W, Javed MA, Mai G, Liu XB, Hu WM, Xia Q. A systematic review and meta-analysis of studies comparing laparoscopic and open distal pancreatectomy. HPB (Oxford). 2012;14:711-724.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 132]  [Cited by in F6Publishing: 118]  [Article Influence: 9.8]  [Reference Citation Analysis (0)]
27.  Mabrut JY, Fernandez-Cruz L, Azagra JS, Bassi C, Delvaux G, Weerts J, Fabre JM, Boulez J, Baulieux J, Peix JL. Laparoscopic pancreatic resection: results of a multicenter European study of 127 patients. Surgery. 2005;137:597-605.  [PubMed]  [DOI]  [Cited in This Article: ]
28.  Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc. 2007;21:373-377.  [PubMed]  [DOI]  [Cited in This Article: ]
29.  Taylor C, O’Rourke N, Nathanson L, Martin I, Hopkins G, Layani L, Ghusn M, Fielding G. Laparoscopic distal pancreatectomy: the Brisbane experience of forty-six cases. HPB (Oxford). 2008;10:38-42.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 59]  [Cited by in F6Publishing: 59]  [Article Influence: 3.7]  [Reference Citation Analysis (0)]
30.  Chu CK, Kooby DA. Laparoscopic surgery for pancreatic tumors. Surg Oncol Clin N Am. 2010;19:311-333.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 11]  [Cited by in F6Publishing: 12]  [Article Influence: 0.9]  [Reference Citation Analysis (0)]
31.  Borja-Cacho D, Al-Refaie WB, Vickers SM, Tuttle TM, Jensen EH. Laparoscopic distal pancreatectomy. J Am Coll Surg. 2009;209:758-765; quiz 800.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 49]  [Cited by in F6Publishing: 61]  [Article Influence: 4.1]  [Reference Citation Analysis (0)]
32.  Nigri GR, Rosman AS, Petrucciani N, Fancellu A, Pisano M, Zorcolo L, Ramacciato G, Melis M. Metaanalysis of trials comparing minimally invasive and open distal pancreatectomies. Surg Endosc. 2011;25:1642-1651.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 123]  [Cited by in F6Publishing: 112]  [Article Influence: 8.0]  [Reference Citation Analysis (0)]
33.  Jusoh AC, Ammori BJ. Laparoscopic versus open distal pancreatectomy: a systematic review of comparative studies. Surg Endosc. 2012;26:904-913.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 107]  [Cited by in F6Publishing: 110]  [Article Influence: 8.5]  [Reference Citation Analysis (0)]
34.  Fox AM, Pitzul K, Bhojani F, Kaplan M, Moulton CA, Wei AC, McGilvray I, Cleary S, Okrainec A. Comparison of outcomes and costs between laparoscopic distal pancreatectomy and open resection at a single center. Surg Endosc. 2012;26:1220-1230.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 64]  [Cited by in F6Publishing: 73]  [Article Influence: 5.6]  [Reference Citation Analysis (0)]
35.  Rehman S, John SK, Lochan R, Jaques BC, Manas DM, Charnley RM, French JJ, White SA. Oncological feasibility of laparoscopic distal pancreatectomy for adenocarcinoma: a single-institution comparative study. World J Surg. 2014;38:476-483.  [PubMed]  [DOI]  [Cited in This Article: ]
36.  Mehta SS, Doumane G, Mura T, Nocca D, Fabre JM. Laparoscopic versus open distal pancreatectomy: a single-institution case-control study. Surg Endosc. 2012;26:402-407.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 63]  [Cited by in F6Publishing: 56]  [Article Influence: 4.3]  [Reference Citation Analysis (0)]
37.  Limongelli P, Belli A, Russo G, Cioffi L, D’Agostino A, Fantini C, Belli G. Laparoscopic and open surgical treatment of left-sided pancreatic lesions: clinical outcomes and cost-effectiveness analysis. Surg Endosc. 2012;26:1830-1836.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 62]  [Cited by in F6Publishing: 72]  [Article Influence: 6.0]  [Reference Citation Analysis (0)]
38.  Abu Hilal M, Hamdan M, Di Fabio F, Pearce NW, Johnson CD. Laparoscopic versus open distal pancreatectomy: a clinical and cost-effectiveness study. Surg Endosc. 2012;26:1670-1674.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 93]  [Cited by in F6Publishing: 83]  [Article Influence: 6.4]  [Reference Citation Analysis (0)]
39.  DiNorcia J, Schrope BA, Lee MK, Reavey PL, Rosen SJ, Lee JA, Chabot JA, Allendorf JD. Laparoscopic distal pancreatectomy offers shorter hospital stays with fewer complications. J Gastrointest Surg. 2010;14:1804-1812.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 78]  [Cited by in F6Publishing: 93]  [Article Influence: 6.6]  [Reference Citation Analysis (0)]
40.  Vijan SS, Ahmed KA, Harmsen WS, Que FG, Reid-Lombardo KM, Nagorney DM, Donohue JH, Farnell MB, Kendrick ML. Laparoscopic vs open distal pancreatectomy: a single-institution comparative study. Arch Surg. 2010;145:616-621.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 129]  [Cited by in F6Publishing: 146]  [Article Influence: 10.4]  [Reference Citation Analysis (0)]
41.  Kooby DA, Hawkins WG, Schmidt CM, Weber SM, Bentrem DJ, Gillespie TW, Sellers JB, Merchant NB, Scoggins CR, Martin RC. A multicenter analysis of distal pancreatectomy for adenocarcinoma: is laparoscopic resection appropriate? J Am Coll Surg. 2010;210:779-785, 786-787.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 229]  [Cited by in F6Publishing: 222]  [Article Influence: 15.9]  [Reference Citation Analysis (0)]
42.  Jayaraman S, Gonen M, Brennan MF, D’Angelica MI, DeMatteo RP, Fong Y, Jarnagin WR, Allen PJ. Laparoscopic distal pancreatectomy: evolution of a technique at a single institution. J Am Coll Surg. 2010;211:503-509.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 126]  [Cited by in F6Publishing: 122]  [Article Influence: 8.7]  [Reference Citation Analysis (0)]
43.  Baker MS, Bentrem DJ, Ujiki MB, Stocker S, Talamonti MS. A prospective single institution comparison of peri-operative outcomes for laparoscopic and open distal pancreatectomy. Surgery. 2009;146:635-643; discussion 643-645.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 87]  [Cited by in F6Publishing: 101]  [Article Influence: 6.7]  [Reference Citation Analysis (0)]
44.  Finan KR, Cannon EE, Kim EJ, Wesley MM, Arnoletti PJ, Heslin MJ, Christein JD. Laparoscopic and open distal pancreatectomy: a comparison of outcomes. Am Surg. 2009;75:671-679; discussion 679-680.  [PubMed]  [DOI]  [Cited in This Article: ]
45.  Kooby DA, Gillespie T, Bentrem D, Nakeeb A, Schmidt MC, Merchant NB, Parikh AA, Martin RC, Scoggins CR, Ahmad S. Left-sided pancreatectomy: a multicenter comparison of laparoscopic and open approaches. Ann Surg. 2008;248:438-446.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 292]  [Cited by in F6Publishing: 320]  [Article Influence: 20.0]  [Reference Citation Analysis (0)]
46.  Eom BW, Jang JY, Lee SE, Han HS, Yoon YS, Kim SW. Clinical outcomes compared between laparoscopic and open distal pancreatectomy. Surg Endosc. 2008;22:1334-1338.  [PubMed]  [DOI]  [Cited in This Article: ]
47.  Velanovich V. Case-control comparison of laparoscopic versus open distal pancreatectomy. J Gastrointest Surg. 2006;10:95-98.  [PubMed]  [DOI]  [Cited in This Article: ]
48.  Bassi C, Dervenis C, Butturini G, Fingerhut A, Yeo C, Izbicki J, Neoptolemos J, Sarr M, Traverso W, Buchler M. Postoperative pancreatic fistula: an international study group (ISGPF) definition. Surgery. 2005;138:8-13.  [PubMed]  [DOI]  [Cited in This Article: ]
49.  Knaebel HP, Diener MK, Wente MN, Büchler MW, Seiler CM. Systematic review and meta-analysis of technique for closure of the pancreatic remnant after distal pancreatectomy. Br J Surg. 2005;92:539-546.  [PubMed]  [DOI]  [Cited in This Article: ]
50.  Kleeff J, Diener MK, Z’graggen K, Hinz U, Wagner M, Bachmann J, Zehetner J, Müller MW, Friess H, Büchler MW. Distal pancreatectomy: risk factors for surgical failure in 302 consecutive cases. Ann Surg. 2007;245:573-582.  [PubMed]  [DOI]  [Cited in This Article: ]
51.  Sheehan MK, Beck K, Creech S, Pickleman J, Aranha GV. Distal pancreatectomy: does the method of closure influence fistula formation? Am Surg. 2002;68:264-267; discussion 267-268.  [PubMed]  [DOI]  [Cited in This Article: ]
52.  Thaker RI, Matthews BD, Linehan DC, Strasberg SM, Eagon JC, Hawkins WG. Absorbable mesh reinforcement of a stapled pancreatic transection line reduces the leak rate with distal pancreatectomy. J Gastrointest Surg. 2007;11:59-65.  [PubMed]  [DOI]  [Cited in This Article: ]
53.  Ferrone CR, Warshaw AL, Rattner DW, Berger D, Zheng H, Rawal B, Rodriguez R, Thayer SP, Fernandez-del Castillo C. Pancreatic fistula rates after 462 distal pancreatectomies: staplers do not decrease fistula rates. J Gastrointest Surg. 2008;12:1691-1697; discussion 1697-1698.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 188]  [Cited by in F6Publishing: 195]  [Article Influence: 12.2]  [Reference Citation Analysis (0)]
54.  Bilimoria KY, Bentrem DJ, Ko CY, Tomlinson JS, Stewart AK, Winchester DP, Talamonti MS. Multimodality therapy for pancreatic cancer in the U.S. : utilization, outcomes, and the effect of hospital volume. Cancer. 2007;110:1227-1234.  [PubMed]  [DOI]  [Cited in This Article: ]
55.  Diener MK, Seiler CM, Rossion I, Kleeff J, Glanemann M, Butturini G, Tomazic A, Bruns CJ, Busch OR, Farkas S. Efficacy of stapler versus hand-sewn closure after distal pancreatectomy (DISPACT): a randomised, controlled multicentre trial. Lancet. 2011;377:1514-1522.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 413]  [Cited by in F6Publishing: 377]  [Article Influence: 29.0]  [Reference Citation Analysis (0)]
56.  Kim SC, Park KT, Hwang JW, Shin HC, Lee SS, Seo DW, Lee SK, Kim MH, Han DJ. Comparative analysis of clinical outcomes for laparoscopic distal pancreatic resection and open distal pancreatic resection at a single institution. Surg Endosc. 2008;22:2261-2268.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 137]  [Cited by in F6Publishing: 123]  [Article Influence: 7.7]  [Reference Citation Analysis (0)]
57.  Warshaw AL. Conservation of the spleen with distal pancreatectomy. Arch Surg. 1988;123:550-553.  [PubMed]  [DOI]  [Cited in This Article: ]
58.  Ferrone CR, Konstantinidis IT, Sahani DV, Wargo JA, Fernandez-del Castillo C, Warshaw AL. Twenty-three years of the Warshaw operation for distal pancreatectomy with preservation of the spleen. Ann Surg. 2011;253:1136-1139.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 92]  [Cited by in F6Publishing: 102]  [Article Influence: 7.8]  [Reference Citation Analysis (0)]
59.  Butturini G, Inama M, Malleo G, Manfredi R, Melotti GL, Piccoli M, Perandini S, Pederzoli P, Bassi C. Perioperative and long-term results of laparoscopic spleen-preserving distal pancreatectomy with or without splenic vessels conservation: a retrospective analysis. J Surg Oncol. 2012;105:387-392.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 51]  [Cited by in F6Publishing: 62]  [Article Influence: 4.8]  [Reference Citation Analysis (0)]
60.  Fernández-Cruz L, Martínez I, Gilabert R, Cesar-Borges G, Astudillo E, Navarro S. Laparoscopic distal pancreatectomy combined with preservation of the spleen for cystic neoplasms of the pancreas. J Gastrointest Surg. 2004;8:493-501.  [PubMed]  [DOI]  [Cited in This Article: ]
61.  Beane JD, Pitt HA, Nakeeb A, Schmidt CM, House MG, Zyromski NJ, Howard TJ, Lillemoe KD. Splenic preserving distal pancreatectomy: does vessel preservation matter? J Am Coll Surg. 2011;212:651-657; discussion 657-658.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 44]  [Cited by in F6Publishing: 43]  [Article Influence: 3.3]  [Reference Citation Analysis (0)]
62.  Song KB, Kim SC, Park JB, Kim YH, Jung YS, Kim MH, Lee SK, Seo DW, Lee SS, Park do H. Single-center experience of laparoscopic left pancreatic resection in 359 consecutive patients: changing the surgical paradigm of left pancreatic resection. Surg Endosc. 2011;25:3364-3372.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 131]  [Cited by in F6Publishing: 143]  [Article Influence: 11.0]  [Reference Citation Analysis (0)]
63.  Choi SH, Seo MA, Hwang HK, Kang CM, Lee WJ. Is it worthwhile to preserve adult spleen in laparoscopic distal pancreatectomy? Perioperative and patient-reported outcome analysis. Surg Endosc. 2012;26:3149-3156.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 39]  [Cited by in F6Publishing: 43]  [Article Influence: 3.6]  [Reference Citation Analysis (0)]
64.  Jean-Philippe Adam B, Fernández-Cruz L, Sa-Cunha A. Laparoscopic spleen-preserving distal pancreatectomy: splenic vessel preservation compared with the Warshaw technique. JAMA Surg. 2013;148:246-252.  [PubMed]  [DOI]  [Cited in This Article: ]
65.  Shimada K, Sakamoto Y, Sano T, Kosuge T. Prognostic factors after distal pancreatectomy with extended lymphadenectomy for invasive pancreatic adenocarcinoma of the body and tail. Surgery. 2006;139:288-295.  [PubMed]  [DOI]  [Cited in This Article: ]
66.  Cho A, Yamamoto H, Nagata M, Takiguchi N, Shimada H, Kainuma O, Souda H, Gunji H, Miyazaki A, Ikeda A. Comparison of laparoscopy-assisted and open pylorus-preserving pancreaticoduodenectomy for periampullary disease. Am J Surg. 2009;198:445-449.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 89]  [Cited by in F6Publishing: 98]  [Article Influence: 6.5]  [Reference Citation Analysis (0)]
67.  Pugliese R, Scandroglio I, Sansonna F, Maggioni D, Costanzi A, Citterio D, Ferrari GC, Di Lernia S, Magistro C. Laparoscopic pancreaticoduodenectomy: a retrospective review of 19 cases. Surg Laparosc Endosc Percutan Tech. 2008;18:13-18.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 75]  [Cited by in F6Publishing: 87]  [Article Influence: 5.4]  [Reference Citation Analysis (0)]
68.  Palanivelu C, Jani K, Senthilnathan P, Parthasarathi R, Rajapandian S, Madhankumar MV. Laparoscopic pancreaticoduodenectomy: technique and outcomes. J Am Coll Surg. 2007;205:222-230.  [PubMed]  [DOI]  [Cited in This Article: ]
69.  Staudacher C, Orsenigo E, Baccari P, Di Palo S, Crippa S. Laparoscopic assisted duodenopancreatectomy. Surg Endosc. 2005;19:352-356.  [PubMed]  [DOI]  [Cited in This Article: ]
70.  Lu B, Cai X, Lu W, Huang Y, Jin X. Laparoscopic pancreaticoduodenectomy to treat cancer of the ampulla of Vater. JSLS. 2006;10:97-100.  [PubMed]  [DOI]  [Cited in This Article: ]
71.  Lee JS, Han JH, Na GH, Choi HJ, Hong TH, You YK, Kim DG. Laparoscopic pancreaticoduodenectomy assisted by mini-laparotomy. Surg Laparosc Endosc Percutan Tech. 2013;23:e98-e102.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 27]  [Cited by in F6Publishing: 31]  [Article Influence: 3.1]  [Reference Citation Analysis (0)]
72.  Suzuki O, Kondo S, Hirano S, Tanaka E, Kato K, Tsuchikawa T, Yano T, Okamura K, Shichinohe T. Laparoscopic pancreaticoduodenectomy combined with minilaparotomy. Surg Today. 2012;42:509-513.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 12]  [Cited by in F6Publishing: 10]  [Article Influence: 0.8]  [Reference Citation Analysis (0)]
73.  Ammori BJ. Laparoscopic hand-assisted pancreaticoduodenectomy: initial UK experience. Surg Endosc. 2004;18:717-718.  [PubMed]  [DOI]  [Cited in This Article: ]
74.  Kimura Y, Hirata K, Mukaiya M, Mizuguchi T, Koito K, Katsuramaki T. Hand-assisted laparoscopic pylorus-preserving pancreaticoduodenectomy for pancreas head disease. Am J Surg. 2005;189:734-737.  [PubMed]  [DOI]  [Cited in This Article: ]
75.  Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases. Surg Endosc. 2006;20:1045-1050.  [PubMed]  [DOI]  [Cited in This Article: ]
76.  Asbun HJ, Stauffer JA. Laparoscopic vs open pancreaticoduodenectomy: overall outcomes and severity of complications using the Accordion Severity Grading System. J Am Coll Surg. 2012;215:810-819.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 287]  [Cited by in F6Publishing: 313]  [Article Influence: 26.1]  [Reference Citation Analysis (0)]
77.  Bao PQ, Mazirka PO, Watkins KT. Retrospective comparison of robot-assisted minimally invasive versus open pancreaticoduodenectomy for periampullary neoplasms. J Gastrointest Surg. 2014;18:682-689.  [PubMed]  [DOI]  [Cited in This Article: ]
78.  Kim SC, Song KB, Jung YS, Kim YH, Park do H, Lee SS, Seo DW, Lee SK, Kim MH, Park KM. Short-term clinical outcomes for 100 consecutive cases of laparoscopic pylorus-preserving pancreatoduodenectomy: improvement with surgical experience. Surg Endosc. 2013;27:95-103.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 140]  [Cited by in F6Publishing: 140]  [Article Influence: 11.7]  [Reference Citation Analysis (0)]
79.  Chalikonda S, Aguilar-Saavedra JR, Walsh RM. Laparoscopic robotic-assisted pancreaticoduodenectomy: a case-matched comparison with open resection. Surg Endosc. 2012;26:2397-2402.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 186]  [Cited by in F6Publishing: 167]  [Article Influence: 13.9]  [Reference Citation Analysis (0)]
80.  Lai EC, Yang GP, Tang CN. Robot-assisted laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy--a comparative study. Int J Surg. 2012;10:475-479.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 144]  [Cited by in F6Publishing: 146]  [Article Influence: 12.2]  [Reference Citation Analysis (0)]
81.  Zeh HJ, Zureikat AH, Secrest A, Dauoudi M, Bartlett D, Moser AJ. Outcomes after robot-assisted pancreaticoduodenectomy for periampullary lesions. Ann Surg Oncol. 2012;19:864-870.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 110]  [Cited by in F6Publishing: 122]  [Article Influence: 9.4]  [Reference Citation Analysis (0)]
82.  Giulianotti PC, Sbrana F, Bianco FM, Elli EF, Shah G, Addeo P, Caravaglios G, Coratti A. Robot-assisted laparoscopic pancreatic surgery: single-surgeon experience. Surg Endosc. 2010;24:1646-1657.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 276]  [Cited by in F6Publishing: 254]  [Article Influence: 18.1]  [Reference Citation Analysis (0)]
83.  Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy: feasibility and outcome in an early experience. Arch Surg. 2010;145:19-23.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 251]  [Cited by in F6Publishing: 282]  [Article Influence: 20.1]  [Reference Citation Analysis (0)]
84.  Palanivelu C, Rajan PS, Rangarajan M, Vaithiswaran V, Senthilnathan P, Parthasarathi R, Praveen Raj P. Evolution in techniques of laparoscopic pancreaticoduodenectomy: a decade long experience from a tertiary center. J Hepatobiliary Pancreat Surg. 2009;16:731-740.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 129]  [Cited by in F6Publishing: 108]  [Article Influence: 7.2]  [Reference Citation Analysis (0)]
85.  Gagner M, Pomp A. Laparoscopic pancreatic resection: Is it worthwhile? J Gastrointest Surg. 1997;1:20-25; discussion 25-26.  [PubMed]  [DOI]  [Cited in This Article: ]
86.  Menon KV, Hayden JD, Prasad KR, Verbeke CS. Total laparoscopic pancreaticoduodenectomy and reconstruction for a cholangiocarcinoma of the bile duct. J Laparoendosc Adv Surg Tech A. 2007;17:775-780.  [PubMed]  [DOI]  [Cited in This Article: ]
87.  Mesleh MG, Stauffer JA, Bowers SP, Asbun HJ. Cost analysis of open and laparoscopic pancreaticoduodenectomy: a single institution comparison. Surg Endosc. 2013;27:4518-4523.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 77]  [Cited by in F6Publishing: 77]  [Article Influence: 7.0]  [Reference Citation Analysis (0)]
88.  Kendrick ML. Laparoscopic and robotic resection for pancreatic cancer. Cancer J. 2012;18:571-576.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 60]  [Cited by in F6Publishing: 68]  [Article Influence: 6.2]  [Reference Citation Analysis (0)]
89.  Gumbs AA, Gayet B. The laparoscopic duodenopancreatectomy: the posterior approach. Surg Endosc. 2008;22:539-540.  [PubMed]  [DOI]  [Cited in This Article: ]
90.  Cirocchi R, Partelli S, Coratti A, Desiderio J, Parisi A, Falconi M. Current status of robotic distal pancreatectomy: a systematic review. Surg Oncol. 2013;22:201-207.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 45]  [Cited by in F6Publishing: 47]  [Article Influence: 4.3]  [Reference Citation Analysis (0)]
91.  Waters JA, Canal DF, Wiebke EA, Dumas RP, Beane JD, Aguilar-Saavedra JR, Ball CG, House MG, Zyromski NJ, Nakeeb A. Robotic distal pancreatectomy: cost effective? Surgery. 2010;148:814-823.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 175]  [Cited by in F6Publishing: 173]  [Article Influence: 12.4]  [Reference Citation Analysis (0)]
92.  Kang CM, Kim DH, Lee WJ, Chi HS. Conventional laparoscopic and robot-assisted spleen-preserving pancreatectomy: does da Vinci have clinical advantages? Surg Endosc. 2011;25:2004-2009.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 147]  [Cited by in F6Publishing: 153]  [Article Influence: 10.9]  [Reference Citation Analysis (0)]
93.  Ntourakis D, Marzano E, Lopez Penza PA, Bachellier P, Jaeck D, Pessaux P. Robotic distal splenopancreatectomy: bridging the gap between pancreatic and minimal access surgery. J Gastrointest Surg. 2010;14:1326-1330.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 17]  [Cited by in F6Publishing: 20]  [Article Influence: 1.4]  [Reference Citation Analysis (0)]
94.  Daouadi M, Zureikat AH, Zenati MS, Choudry H, Tsung A, Bartlett DL, Hughes SJ, Lee KK, Moser AJ, Zeh HJ. Robot-assisted minimally invasive distal pancreatectomy is superior to the laparoscopic technique. Ann Surg. 2013;257:128-132.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 233]  [Cited by in F6Publishing: 257]  [Article Influence: 23.4]  [Reference Citation Analysis (0)]
95.  Hwang HK, Kang CM, Chung YE, Kim KA, Choi SH, Lee WJ. Robot-assisted spleen-preserving distal pancreatectomy: a single surgeon’s experiences and proposal of clinical application. Surg Endosc. 2013;27:774-781.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 53]  [Cited by in F6Publishing: 53]  [Article Influence: 4.4]  [Reference Citation Analysis (0)]
96.  Cirocchi R, Partelli S, Trastulli S, Coratti A, Parisi A, Falconi M. A systematic review on robotic pancreaticoduodenectomy. Surg Oncol. 2013;22:238-246.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 65]  [Cited by in F6Publishing: 70]  [Article Influence: 6.4]  [Reference Citation Analysis (0)]
97.  Boggi U, Signori S, De Lio N, Perrone VG, Vistoli F, Belluomini M, Cappelli C, Amorese G, Mosca F. Feasibility of robotic pancreaticoduodenectomy. Br J Surg. 2013;100:917-925.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 135]  [Cited by in F6Publishing: 149]  [Article Influence: 13.5]  [Reference Citation Analysis (0)]
98.  Choi SH, Kang CM, Kim DH, Lee WJ, Chi HS. Robotic pylorus preserving pancreaticoduodenectomy with mini-laparotomy reconstruction in patient with ampullary adenoma. J Korean Surg Soc. 2011;81:355-359.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 8]  [Cited by in F6Publishing: 8]  [Article Influence: 0.6]  [Reference Citation Analysis (0)]
99.  Chan OC, Tang CN, Lai EC, Yang GP, Li MK. Robotic hepatobiliary and pancreatic surgery: a cohort study. J Hepatobiliary Pancreat Sci. 2011;18:471-480.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 70]  [Cited by in F6Publishing: 76]  [Article Influence: 5.8]  [Reference Citation Analysis (0)]
100.  Zhou NX, Chen JZ, Liu Q, Zhang X, Wang Z, Ren S, Chen XF. Outcomes of pancreatoduodenectomy with robotic surgery versus open surgery. Int J Med Robot. 2011;7:131-137.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 95]  [Cited by in F6Publishing: 96]  [Article Influence: 7.4]  [Reference Citation Analysis (0)]
101.  Narula VK, Mikami DJ, Melvin WS. Robotic and laparoscopic pancreaticoduodenectomy: a hybrid approach. Pancreas. 2010;39:160-164.  [PubMed]  [DOI]  [Cited in This Article: ]  [Cited by in Crossref: 66]  [Cited by in F6Publishing: 69]  [Article Influence: 4.9]  [Reference Citation Analysis (0)]
102.  Zureikat AH, Moser AJ, Boone BA, Bartlett DL, Zenati M, Zeh HJ. 250 robotic pancreatic resections: safety and feasibility. Ann Surg. 2013;258:554-559; discussion 559-562.  [PubMed]  [DOI]  [Cited in This Article: ]