Learning Curve for Laparoscopic Pancreaticoduodenectomy: A Single Surgeon's Experience with Consecutive Patients

Background/Aims: Laparoscopic pancreaticoduodenectomy (LPD) is regarded as one of the most complex surgical procedures. The aim of this study was to examine a single surgeon's learning curve for LPD in consecutive cases. Methodology: Thirty consecutive patients who underwent an LPD by the same single surgeon were divided into three groups (A, B, and C; 10 cases each). Postoperative complications, operative time, and blood loss for each group were compared. Results: There were no significant differences in the occurrence of postoperative complications among the groups. There were significant differences in both operative time and blood loss between groupA (mean operative time, 796.8 mm; mean blood loss 546.2 mL) and group B (mean operative time, 563.9 mm; mean blood loss 242.0 mL), and between groups A and C (mean operative time, 515.8 mm; mean blood loss 283.0 mL). Regarding operative time and blood loss, the surgeon reached a learning curve plateau after 10 cases/LPD procedures. Conclusions: LPD is a feasible and safe surgical procedure with a steep learning curve when performed by a surgeon who is experience in open PD, and LPD provides the advantages that would be expected from a minimally invasive surgery.