Total laparoscopic pancreaticoduodenectomy: a retrospective study of 27 cases treated in a single institution

Gagne and Pomp performed the first reported laparoscopic pancreaticoduodenectomy (LPD) in a 30-year-old woman with chronic pancreatitis in 1994 (1). Because this procedure is extremely difficult and there is a high incidence of postoperative complications, some researchers have raised doubts about its efficacy (2-4). Acceptance has probably been slowed by both the inherent technical limitations of laparoscopy and the need for advanced endoscopic skills which, until recently, surgeons have not acquired during their training (5,6)