Two-surgeon Model in Laparoscopic Pancreaticoduodenectomy

Purpose: Laparoscopic pancreaticoduodenectomy (LPD) is one of the most challenging gastrointestinal surgeries. Herein, we propose a new laparoscopic surgical conception called the 2-surgeon model and share our experience in LPD. Materials and Methods: We began performing LPD using the 2-surgeon model in October 2015. To December 2017, we have performed 203 cases of LPDs using 2-surgeon model. Data associated with demographic characteristics, operative outcomes, and postoperative results were prospectively collected and analyzed retrospectively. Results: Only 1 patient in our series required to conversion to open surgery. The mean operative time was 318 minute. The estimated blood loss was 108 mL. The overall complication was 26.1%. In total, 41 patients (20.2%) suffered from pancreatic fistula, including 33 cases of grade A, 7 cases of grade B, and 1 case of grade C. The 90-day mortality was 0.5%. Conclusions: The 2-surgeon model is safe and feasible for LPD.