Compared with open surgery, laparoscopic radical resection of the body and tail pancreatic cancer is gradually being accepted due to its shorter hospital stay, reduced intraoperative blood loss, and comparable perioperative and oncological prognosis. The proposal of radical antegrade modular pancreatosplenectomy (RAMPS) has established a standardized approach for resection scope and lymph node dissection in pancreatic body and tail cancers. Studies have confirmed that RAMPS surgery can achieve a higher N1 station lymph node dissection, R0 margin ratio, and satisfactory patient survival rates. Furthermore, RAMPS has demonstrated oncological advantages in terms of postoperative local control. Laparoscopic RAMPS (LRAMPS) has been shown to be technically feasible and to yield long-term oncologic outcomes comparable to open RAMPS. An increasing number of studies have evaluated LRAMPS as the standard surgical modality for resectable body and tail pancreatic cancers. This article discusses the main points and challenges of LRAMPS surgery, and presents some personal experiences.
The detection rate of benign and borderline/low-grade malignant tumors of pancreas has increased year by year. Most of the patients are middle-aged and young people, who have thirst for high quality of life in long-term. Pancreatic-duct-preserving partial pancreatectomy can meet the needs of reducing surgical trauma, preserving normal pancreatic function and improving patients’ quality of life. However, pancreatic-duct-preserving partial pancreatectomy often needs to face the problem of pancreatic duct defect. Repair of pancreatic duct needs to be applied according to different types of pancreatic duct defect. At the same time, the prevention and treatment of pancreatic fistula also require more patience, courage and creativity of pancreatic surgeons. Pancreatic-duct-preserving partial pancreatectomy can solve the current clinical problems. It is safe and feasible with carefully evaluate indications, characters of patients and the personal ability of surgeons.