Background : Laparoscopic pancreaticoduodenectomy (LPD) has been proved recently as feasible procedure in treating of periampullary tumor. However, LPD is still complicated and challenging operation for the beginner in field of minimally invasive pancreas surgery. We investigated early outcomes of minimally invasive pancreaticoduodenectomy of novice surgeons.

Methods : From May 2020 to October 2021, total 25 patients underwent pancreaticoduodenectomy by two novice surgeons in the fledgling medical center who just finished their fellowship training in two years. Clinical characteristics and preoperative laboratory findings, immediate postoperative outcomes were compared between LPD and open pancreaticoduodenectomy (OPD).

Results : Total 25 patients were included, and LPD was performed in 10 patients (40%). No 30 day, and 90 day mortality was noted. Clinical relevant postoperative fistula (CR-POPF) and postoperative complications (Clavian-Dindo>=3) were, 30.0%, and 26.7%, respectively. There were no statistically significant differences in terms of sex, body mass index and age. Most common diagnosis was common bile duct cancer in LPD group (n=4, 40.0%). In OPD group, common bile duct cancer and pancreatic cancer were most common diagnosis, respectively (n=4, 26.7%). Operation time was significant different between LPD (713.6 min) and OPD group (537.7min) (p=0.004). Other variables, such as estimated blood loss, transfusion, resection status, retrieved lymph nodes were not significantly different. Postoperative outcomes including postoperative pancreatic fistula proportion, bile leakage, delayed emptying showed no differences between two groups.

Conclusions : PD could be safely performed by novice surgeons in fledgling medical center. Especially, LPD is also feasible, safe, and comparable to OPD in well-selected patients. However, longer operation time is expected to be reduced after learning curve period.