Laparoscopic Treatment of Duodenal Cephalic Pancreatic Tumors

Pancreatic head cancer is one of the deadliest malignancies worldwide with poor prognosis and high mortality. The identification of this cancer often occurs in advanced stages, so surgery remains the treatment of this disease. Several investigations are used to stage this disease for resectability purposes. To date, the pancreatic head resection surgical technique, also known as the Whipple procedure, is considered one of the most difficult surgical procedures as the surgeon needs a good knowledge of the anatomical variants and above all the ability to evaluate the severity of the disease. Despite the complexity of this technique, the laparoscopic approach has advantages in terms of hospitalization times, blood loss, and lymph node dissection. Obviously, despite the advantages, the laparoscopic approach requires greater dexterity on the part of the surgeon. For these reasons, laparoscopic duodenopancreatectomy is the prerogative of highly experienced surgeons and is reserved for reference centers in particular with experience in the hepato-biliary-pancreatic field. In the next chapter, the laparoscopic Whipple procedure is accurately described, deepening the anatomical aspects, technical details, and the perioperative management of the patient.