Letter to the Editor
Response to the Letter to the Editor on the article “Highs and lows in laparoscopic pancreaticoduodenectomy”
Luces y sombras de la duodenopancreatectomía cefálica laparoscópica
Francisco Espín
, María Isabel García-Domingo, Manel Cremades, Esteban Cugat
Corresponding author
Hospital Universitari Germans Trias i Pujol, Cataluña, Spain
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In our opinion, pancreatic surgery in general and pancreaticoduodenectomy in particular should combine appropriate oncological results with fast recovery and the best possible functional status for facing adjuvant treatment.</p><p id="par0015" class="elsevierStylePara elsevierViewall">As mentioned in the article, laparoscopic pancreaticoduodenectomy (LPD) is not widely accepted, and its use is controversial.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">2</span></a> In our opinion, as suggested by the authors of this letter, a correct patient selection and appropriate training in pancreatic surgery and laparoscopy will be able to establish its role and the hypothetical advantages of LPD.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The authors of the present letter to the editor point out that in the series, no cases of pancreatic fistula were observed in the open surgery group. However, B/C pancreatic fistula was observed in 7 cases in the open pancreaticoduodenectomy group (rate 22.6%) with no cases of biochemical leak. In front no cases and 2 cases (8.7%) in the LPD group, respectively.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a> These differences did not have statistically significance and in our opinion, the selection of the patients, with probably different characteristics regarding the risk of pancreatic fistula could explain these results. In any case, pancreatic fistula was not the main objective of the study.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">1</span></a></p><p id="par0025" class="elsevierStylePara elsevierViewall">Finally, we want to add a reflection in relation to the revolution in pancreatic surgery that supposes the incorporation of the robotic surgery. Although been daring, we could presuppose that the incorporation of robotics can condition the quality and quantity of clinical trials that evaluate the laparoscopic approach in pancreatic surgery.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">3,4</span></a></p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:4 [ 0 => array:3 [ "identificador" => "bib0025" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Highs and lows in laparoscopic pancreaticoduodenectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "F. Espin Alvarez" 1 => "M.I. García Domingo" 2 => "M. Cremades Pérez" 3 => "E. Herrero Fonollosa" 4 => "J. Navinés López" 5 => "J. 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