Abstract

ARAGON QUINTANA, César; GUEVARA LOPEZ, Javier Antero; CASAS GARCIA, Juan Carlos  and  CASTILLO FRAUSTO, Adriana. Experience in handling pancreatic cancer with laparoscopic Whipple at the General and Central Hospital of Chihuahua. Cir. gen [online]. 2017, vol.39, n.3, pp.152-156. ISSN 1405-0099.

Pancreatic cancers are usually aggressive malignancies with high mortality rates, which can be solid or cystic. The most common solid pancreatic neoplasms are pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumors (PNET). In Mexico, pancreatic cancer is the fifth most common malignancy in men and seventh in women. The clinical presentation of pancreatic cancer depends primarily on the location of the tumor within the pancreas. Most (85%) of pancreatic cancers develop inside the head of the pancreas. About 10% occur in the pancreatic body and 5% in the tail. Diagnosis of pancreatic cancer is established may be difficult to diagnose, in those patients who present with obstructive jaundice, suspicion of pancreatic cancer is very high are performed various imaging studies such as abdominal ultrasound or CT scan of the abdomen, or both. Whipple surgery or pancreatoduodenectomy is the only potentially curative therapy for the treatment of resectable pancreatic cancer. The operative mortality rate in experienced surgeons is less than 5% and high as 20%-30%. Postoperative deaths are due to complications such as pancreatic and biliary fistulas, bleeding and infection. Studies comparing open pancreatoduodenectomy (OPD) and laparoscopic pancreatoduodenectomy (LPD) found decreased blood loss, longer surgical time, similar rate of post-operative complications, decreased pain and shorter length of hospital stay in patients undergoing LPD. In this study, 8 patients with a mean age of 53 years (52.87) and a diagnosis of resectable pancreatic cancer were involved. The imaging studies obtained were computed tomography and endoscopic retrograde cholangiopancreatography. Pancreatoduodenectomy was performed in 5 patients (average operating time 280 minutes and blood loss of 837.5 ml), 2 of the patients were converted to open surgery, 2 of the patients died. Complications of the procedure included: high expenditure pancreatic fistula, biliary leakage and intra-abdominal abscesses. The average hospital stay was 11 days.

Keywords : Pancreatic cancer; Whipple’s surgery or pancreatoduodenectomy; treatment of resectable pancreatic cancer; open versus laparoscopic pancreatoduodenectomy.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )