Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival

Lee M. Ocuin, Jennifer L. Miller-Ocuin, Stephanie M. Novak, David L. Bartlett, J. Wallis Marsh, Allan Tsung, Kenneth K. Lee, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat

Research output: Contribution to journalArticle

20 Scopus citations

Abstract

Background Distal pancreatectomy with celiac axis resection (DP-CAR) is an option for T4 tumors of the pancreatic body. We examined the perioperative and oncologic outcomes of open and robotic DP-CAR at a high-volume pancreatic center. Methods Retrospective review of all consecutive DP-CARs. Patient demographics, 90-day perioperative outcomes, and disease specific survival were collected. Results 30 DP-CARs were performed (11 Robotic, 19 Open). Both groups had similar preoperative/tumor characteristics, and 27 of 28 PDA patients received neoadjuvant chemotherapy. Robotic DP-CAR was associated with decreased OT (316 vs. 476 min), reduced EBL (393 vs. 1736 ml) and lower rates of blood transfusion (0% vs. 54%) (all p < 0.05). No robotic DP-CAR required conversion. Both groups had similar rates of 90-day mortality, major morbidity, LOS, readmission, and receipt of adjuvant therapy. Similarly, both approaches were associated with high R0 resection rates (82% vs. 79%). At a median follow-up of 33 months, median overall survival for the PDA cohort was 35 months, with no difference in the robotic and open approach (33 and 40 months, p = 0.310). Conclusions With a median survival approaching 3 years, DP-CAR represents an effective treatment for select patients with locally advanced pancreatic body cancer, regardless of approach.

Original languageEnglish (US)
Pages (from-to)835-842
Number of pages8
JournalHPB
Volume18
Issue number10
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Ocuin, L. M., Miller-Ocuin, J. L., Novak, S. M., Bartlett, D. L., Marsh, J. W., Tsung, A., Lee, K. K., Hogg, M. E., Zeh, H. J., & Zureikat, A. H. (2016). Robotic and open distal pancreatectomy with celiac axis resection for locally advanced pancreatic body tumors: a single institutional assessment of perioperative outcomes and survival. HPB, 18(10), 835-842. https://doi.org/10.1016/j.hpb.2016.05.003