Abstract
Background: Central pancreatectomy is a definitive treatment for low-grade tumors of the pancreatic neck that preserves pancreatic and splenic function at the potential expense of postoperative pancreatic fistula. We analyzed outcomes after robot-assisted central pancreatectomy (RACP) to reexamine the risk-benefit profile in the era of minimally invasive surgery. Methods: Retrospective analysis of nine RACP performed between August 2009 through June 2010 at a single institution. Results: The average age of the cohort was 64 (range 18-75 years) with six women (67 %). Indications for surgery included: five benign cystic neoplasm and four pancreatic neuroendocrine tumor. Median operative time was 425 min (range 305-506 min) with 190 ml median blood loss (range 50-350 ml) and one conversion to open due to poor visualization. Median tumor size was 3. 0 cm (range 1. 9-6. 0 cm); all patients achieved R0 status. Pancreaticogastrostomy was performed in seven cases and pancreaticojejunostomy in two. The median length of hospital stay was 10 days (range 7-19). Two clinically significant pancreatic fistulae occurred with one requiring percutaneous drainage. No patients exhibited worsening diabetes or exocrine insufficiency at the 30-day postoperative visit. Conclusions: RACP can be performed with safety and oncologic outcomes equivalent to published open series. Although the rate of pancreatic fistula was high, only 22 % had clinically significant events, and none developed worsening pancreatic endocrine or exocrine dysfunction.
Original language | English (US) |
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Pages (from-to) | 1002-1008 |
Number of pages | 7 |
Journal | Journal of Gastrointestinal Surgery |
Volume | 17 |
Issue number | 5 |
DOIs | |
State | Published - May 2013 |
Externally published | Yes |
Keywords
- Minimally invasive
- Pancreatectomy
- Robotics
- Surgical procedure
ASJC Scopus subject areas
- Surgery
- Gastroenterology