ObjectiveTo discuss application of " counter clockwise resection” in total laparoscopic pan-creaticoduodenectomy (TLPD) and summarize it’s preliminary experiences.MethodThe clinical data of consecutive 8 patients underwent TLPD in the Department of Pancreatic Surgery, Affiliated Shengjing Hospital of China Medical University from July 2016 to January 2017 were analyzed retrospectively.ResultsThere were 3 males and 5 females in these 8 patients. The age was (64.13±15.01) years. The results of postoperative pathology included 1 duodenal cancer, 2 distal biliary tract cancers, 4 pancreatic head cancers, and 1 solid pseudopapillary tumor of pancreatic head. All the 8 patients were performed with TLPD successfully, and the time of the operation was (527.50±69.44) min, the resection time of the specimen was (241.25±38.71) min, and the blood loss was (368.75±162.43) mL, the postoperative hospitalization stay was (18.67±4.00) d. There were no postoperative bleeding, perioperative death, and delayed gastric emptying．Four patients suffered from the pancreatic fistula including 3 cases of grade A and 1 case of grade B pancreatic fistulas, and 1 case suffered from the intra-abdominal infection, who were cured after the conservative treatment. All the patients were following-up, and there was no abnormality.ConclusionPreliminary results of limited cases in this study show that " counter clockwise resection” might be a safe, effective, and easy method of TLPD, but further research is need to study.
