Robotic-Assisted Minimally Invasive Central Pancreatectomy: Technique and Outcomes

Gerard J. Abood, M. Fatih Can, Mustapha Daouadi, Harold T. Huss, Jennifer Y. Steve, Lekshmi Ramalingam, Michael Stang, David L. Bartlett, Herbert J. Zeh, A. James Moser

Research output: Contribution to journalArticlepeer-review

27 Scopus citations

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 languageEnglish (US)
Pages (from-to)1002-1008
Number of pages7
JournalJournal of Gastrointestinal Surgery
Volume17
Issue number5
DOIs
StatePublished - Jan 16 2013
Externally publishedYes

Keywords

  • Minimally invasive
  • Pancreatectomy
  • Robotics
  • Surgical procedure

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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