Abstract
Laparoscopic pancreatectomy has gained popularity in recent years. However, the consensus regarding the safety of this procedure remains inconsistent. We reviewed the articles regarding laparoscopic pancreatectomy (LP). In Japan, each institution is required to fulfill the strict facility criteria to perform laparoscopic distal pancreatectomy (LDP) and laparoscopic pancreatoduodenectomy (LPD) and must gain the approval. Based on this condition, LDP is recommended for benign to low malignant tumors because LDP can decrease the frequency of complications compared to open surgery. We consider that LDP for pancreatic cancer is also recommended because LDP is equivalent to open surgery in terms of perioperative outcomes, but further accumulation of clinical cases and analyses of short and long-term outcomes are mandatory. Regarding laparoscopic pancreatoduodenectomy (LPD), the procedure is recommended only for benign to low malignant tumors in experienced institution, because it can offer an equivalent or superior outcome to the open surgery. As of October 2018, the indication for malignant tumors is out of the insurance coverage and its future approval is expected.
