MINISTRY OF EDUCATION AND TRAINING MINISTRY OF NATIONAL DEFENCE VIETNAM MILITARY MEDICAL UNIVERSITY HOANG CONG LAM THE STUDY APPLICATION OF LAPAROSCOPIC PANCREATICODUODENECTOMY Speciality: Gastrointestinal surgery Code: 90 20 104 Ph.D THESIS ABSTRACT Hanoi - 2019 THE THESIS WAS COMPLETED IN VIETNAM MILITARY MEDICAL UNIVERSITY Scientific supervisors: TRAN BINH GIANG, M.D., Ph.D., Prof HOANG MANH AN, M.D., Ph.D., Assoc Prof Thesis reriewer 1:PHAM NHU HIEP, M.D., Ph.D., Prof Thesis reriewer 2:TRIEU TRIEU DUONG, M.D., Ph.D., Assoc Prof Thesis reriewer 3: NGUYEN NGOC BICH, M.D., Ph.D., Prof The Thesis was presented at the University Scientific Research Council of Vietnam Military Medical University at , 2019 Thesis can be found at: Vietnam National Library Library of Vietnam Military Medical University A INTRODUCTION *QUESTION Laparoscopic pancreaticoduodenectomy (LPD) is technique of block resection of the duodenum, the pancreatic head, a part of the common bile duct, gallbladder, a part of the stomach and the first part of the jejunum, which Whipple successfully performed for the first time in humans in 1935 In 1994, LPD was performed by Gagner and Pomp There have been studies compared between open pancreaticoduodenectomy (OPD) and LPD, which showed that the laparoscopic surgery reduced blood loss, longer surgery time, no significant statistical difference of complication rate, shorter hospital stay; a greater number of dredged lymph nodes, and especially, less level of pain Indications for LPD are usually only compatible for tumor lesions of the pancreatic head, Vater ampulla, low common bile duct, duodenum, and chronic pancreatitis at their early stage, etc Some prestige healthcare facilities have reported the mass application of pancreaticoduodenectomy with complete endoscopy or supportive endoscopy such as Viet Duc Friendship Hospital, 103 Military Medical Hospital, Bach Mai Hospital, University of Medicine and Pharmacy, Ho Chi Minh City, etc In which, initial outcomes were comparable or better than open surgeries However, there has not been a systematic assessment of the indication, complete description of the technical characteristics, advantages, and disadvantages of each step, but only the outcomes of this method So, it is necessary to have follow-up studies on LPD, in order to have a comprehensive assessment which is based on to build up guidelines of necessary indications and recommendations for surgeons Stemming from the above reasons, authors conducted the research "The study in the application of laparoscopic pancreaticoduodenectomy" with objectives: Identify indications and technical specifications of LPD Assess the outcomes of LPD * NEW MAIN CONTRIBUTIONS OF THE THESIS The study was a retrospective and prospective study of 36 patients with LPD: the thesis showed that laparoscopic pancreaticoduodenectomy was designed for diseases related to tumors at the pancreatic head, Vater tumors, low common bile duct tumors, tumors at the second part of the duodenum, chronic pancreatitis with tumor size