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.