Laparoscopic pancreatoduodenectomy: How far have we come and where are we headed?

Core Tip

Core tip: This editorial while discussing the evidence and controversies surrounding minimally invasive pancreatoduodenectomy, aims to update the reader about the highest level of evidence accumulated over the past few years. Pancreatoduodenectomy remains a demanding procedure even in the open approach and only few surgeons in high volume centres have published the outcomes following minimally invasive pancreatoduodenectomy. All these reports are retrospective data with inherent problems related to bias. To settle this issue, any randomized trial is unlikely to happen given the complexity of the cancer and patient selection for surgery in a resectable cancer. All these issues have been addressed in this editorial so that the pros and cons of minimally invasive pancreatoduodenectomy have been well conveyed and the reader takes home a balanced message.