• Zhao Liu, Mu-Chuan Yu, Rui Zhao, Yan-Feng Liu, Jian-Ping Zeng, Xian-Qiang Wang, and Jing-Wang Tan.
• Zhao Liu, Department of Hepatobiliary and Pancreatic Surgery, Jinan Central Hospital, Shandong University, Jinan 250012, Shandong Province, China.
• World J. Gastroenterol. 2015 Feb 7;21(5):1588-94.

AimTo evaluate the feasibility, safety, and efficacy of laparoscopic pancreaticoduodenectomy (LPD) using a reverse-"V" approach with four ports.MethodsThis is a retrospective study of selected patients who underwent LPD at our center between April 2011 and April 2012. The following data were collected and reviewed: patient characteristics, tumor histology, surgical outcome, resection margins, morbidity, and mortality. All patients were thoroughly evaluated preoperatively by complete hematologic investigations, triple-phase helical computed tomography, upper gastrointestinal endoscopy, and biopsy of ampullary lesions (when present). Magnetic resonance cholangiopancreatography was performed for doubtful cases of lower common bile duct lesions.ResultsThere was no perioperative mortality. LPD was performed with tumor-free margins in all patients, including patients with pancreatic ductal adenocarcinoma (n = 6), ampullary carcinoma (n = 6), intra-ductal papillary mucinous neoplasm (n = 2), pancreatic cystadenocarcinoma (n = 2), pancreatic head adenocarcinoma (n = 3), and bile duct cancer (n = 2). The mean patient age was 65 years (range, 42-75 years). The median blood loss was 240 mL, and the mean operative time was 368 min.ConclusionLPD using a reverse-"V" approach can be performed safely and yields good results in elective patients. Our preliminary experience showed that LDP can be performed via a reverse-"V" approach. This approach can be used to treat localized malignant lesions irrespective of histopathology.

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