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w alternative therapeutic option for childhood with AUA, especially for families who are reluctant to undergo an appendectomy. Although early series focused on benign disease, minimally invasive pancreatoduodenectomy (MIPD) might be particularly suited for malignancy. Unlike their predecessors, fellowship-trained (FT) Hepatic-Pancreatic and Biliary (HP surgeons usually have equal skills in approaching peri-ampullary tumors (PT) either openly or via minimally invasive (MI) techniques. We retrospectively reviewed a MI-HPB-FT surgeon's 10