Laparoscopic Pancreatic Head Preserving Total Duodenectomy: The Parenchymal Sparing Alternative to a Whipple.

Background: When endoscopic options fail, laparoscopic pancreatic head-preserving duodenectomy (LPHPD) for benign duodenal lesions is a parenchymal sparing and safe alternative to a pancreaticoduodenectomy.1-3 LPHPD may be the optimal "amount" of surgery, because such lesions are at risk for undertreatment (partial endoscopic resection associated with recurrence) or overtreatment (Whipple associated with morbidity and loss of pancreatic parenchyma).4,5 PATIENT: A 80-year-old, healthy female patient was diagnosed endoscopically with two, flat, symptomatic adenomas (7-cm D2; 2-cm D3).

Laparoscopic Segment 1 with Partial IVC Resection in Advanced Cirrhosis: How to Do It Safely.

Background: Laparoscopic versus open hepatocellular carcinoma (HCC) resection reduces morbidity without a compromise in oncologic safety.14 Moreover, in the subgroup of cirrhotic patients, a decreased risk of prolonged postoperative ascites and liver decompensation has been reported.57 METHODS: A 54-year-old homeless, deaf male with chronic alcoholism, hepatitis C, and advanced cirrhosis was referred with a caudate tumor from a critical access hospital.