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Robotic-Assisted Minimally Invasive Central Pancreatectomy: Technique and Outcomes

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Journal of Gastrointestinal Surgery Aims and scope

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.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, 2160 S. First Avenue, Maywood, IL, 60153, USA

    Gerard J. Abood

  2. UPMC Pancreatic Cancer Center, Division of Surgical Oncology, University of Pittsburgh School of Medicine and Cancer Institute, 5150 Centre Avenue, Suite 421, Pittsburgh, PA, 15232, USA

    M. Fatih Can, Mustapha Daouadi, Harold T. Huss, Jennifer Y. Steve, Lekshmi Ramalingam, Michael Stang, David L. Bartlett & Herbert J. Zeh III

  3. Beth Israel Deaconess Medical Center, Institute for Hepatobiliary and Pancreatic Surgery, Stoneman 9, 330 Brookline Ave., Boston, MA, 02215, USA

    A. James Moser

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  1. Gerard J. Abood
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  2. M. Fatih Can
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  3. Mustapha Daouadi
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  4. Harold T. Huss
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Correspondence to Herbert J. Zeh III or A. James Moser.

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Abood, G.J., Can, M.F., Daouadi, M. et al. Robotic-Assisted Minimally Invasive Central Pancreatectomy: Technique and Outcomes. J Gastrointest Surg 17, 1002–1008 (2013). https://doi.org/10.1007/s11605-012-2137-6

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  • DOI: https://doi.org/10.1007/s11605-012-2137-6

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