Robotic-assisted major pancreatic resection and reconstruction

Amer H. Zureikat, Kevin T. Nguyen, David L. Bartlett, Herbert J. Zeh, A. James Moser

Research output: Contribution to journalArticle

74 Scopus citations

Abstract

Hypothesis: Robotic-assisted pancreatic resection and reconstruction are safe and can reproduce perioperative results seen in open surgery. Design: Single-institution retrospective review. Setting: Tertiary care center. Patients: Patients undergoing completed roboticassisted pancreatic resection and reconstruction at the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, between October 3, 2008, and February 26, 2010. Main Outcome Measures: Primary pathology, operative time, operative blood loss, perioperative blood transfusions, pancreatic fistula, 90-day morbidity and mortality, and readmission rate. Results: Thirty patients with a median age of 70 years (range, 32-85 years) underwent completed roboticassisted pancreatic resection and reconstruction. Procedures were robotic-assisted non-pylorus-preserving pancreaticoduodenectomy (n=24), robotic-assisted central pancreatectomy (n=4), and the robotic-assisted Frey procedure (n=2). The median operative time was 512 minutes (range, 327-848 minutes). The median blood loss was 320mL(range, 50-1000 mL), with a median length of hospital stay of 9 days (range, 4-87 days). The final diagnoses included periampullary adenocarcinoma (n=7), pancreatic ductal adenocarcinoma (n=6), pancreatic neuroendocrine tumor (n=5), intraductal papillary mucinous neoplasm (n=4), mucinous cystic neoplasm (n=3), serous cysticadenoma(n=2), chronic pancreatitis (n=2),andsolid pseudopapillary neoplasm (n=1). There was 1 postoperative death.Theoverall pancreatic fistula ratewas27%(n=8). The clinically significant pancreatic fistula rate (International Study Group on Pancreatic Fistula grades B and C) was 10% (n=3). Clavien grade III and IV complications occurred in 7 patients (23%), while Clavien grade I and II complications occurred in 8 patients (27%). Conclusions: Robotic-assisted complex pancreatic surgery can be performed safely in a high-volume pancreatic tertiary care center with perioperative outcomes comparable to those of open surgery. Advances in robotic technology and increasing experience may improve long operative times.

Original languageEnglish (US)
Pages (from-to)256-261
Number of pages6
JournalArchives of Surgery
Volume146
Issue number3
DOIs
StatePublished - Mar 1 2011

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ASJC Scopus subject areas

  • Surgery

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Zureikat, A. H., Nguyen, K. T., Bartlett, D. L., Zeh, H. J., & Moser, A. J. (2011). Robotic-assisted major pancreatic resection and reconstruction. Archives of Surgery, 146(3), 256-261. https://doi.org/10.1001/archsurg.2010.246