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Addeo. Mini-invasive Surg 2020;4:64 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.47

Systematic Review Open Access

Minimally invasive pancreaticoduodenectomy with
venous resection: results of a systematic review

Pietro Addeo 1,2

1 Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies Digestives, Hépatiques et de la Transplantation,
Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Strasbourg 67098, France.
2 Images team, ICube, Université de Strasbourg, CNRS UMR 7357, Illkirch 67400, France.

Correspondence to: Dr. Pietro Addeo, Hepato-Pancreato-Biliary Surgery and Liver transplantation, Pôle des Pathologies
Digestives, Hépatiques et de la Transplantation, Hôpital de Hautepierre-Hôpitaux Universitaires de Strasbourg, Avenue Molière,
Université de Strasbourg 1, Strasbourg 67098, France. E-mail: pietrofrancesco.addeo@chru-strasbourg.fr

How to cite this article: Addeo P. Minimally invasive pancreaticoduodenectomy with venous resection: results of a systematic
review. Mini-invasive Surg 2020;4:64. http://dx.doi.org/10.20517/2574-1225.2020.47

Received: 5 May 2020 First Decision: 19 Jun 2020 Revised: 27 Aug 2020 Accepted: 31 Aug 2020 Published: 12 Oct 2020
Academic Editor: Giulio Belli Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Aim: Growing experience with minimally invasive pancreaticoduodenectomy (PD) has led surgeons to expand
the indications for this approach. We systematically reviewed the literature on minimally invasive PD with venous
resection.

Methods: The EMBASE, MEDLINE, and Cochrane central databases were systematically searched for articles
from January 2010 to January 2020 describing cases of PD with venous resection. The search was conducted
in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The
primary outcomes were feasibility and conversion rate. Secondary outcomes were morbidity, mortality, blood loss
and 1-year survival.

Results: The literature search found 9 studies reporting 140 patients undergoing PD with venous resection. Sixty-six
PDs were performed robotically (47.1%). The conversion rate ranged from 0% to 55%, blood loss ranged from
200 to 842 mL, and operative time ranged from 397 to 518 min. There were 82 lateral (58.5%) and 18 segmental
(12.8%) PDs with venous resection. One patient had an associated arterial resection (0.7%). A graft was used for
venous reconstruction in 28 patients (20%). Eight deaths (5.7%) were reported postoperatively.

Conclusion: Minimally invasive pancreatectomies with synchronous lateral venous resections are increasingly
reported by highly experienced surgeons in high-volume institutions. Further experience is needed to validate this
approach and prove its advantages over open surgery.
© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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