TY - JOUR
T1 - Robotic-assisted major pancreatic resection and reconstruction
AU - Zureikat, Amer H.
AU - Nguyen, Kevin T.
AU - Bartlett, David L.
AU - Zeh, Herbert J.
AU - Moser, A. James
PY - 2011/3
Y1 - 2011/3
N2 - 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.
AB - 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.
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U2 - 10.1001/archsurg.2010.246
DO - 10.1001/archsurg.2010.246
M3 - Article
C2 - 21079111
AN - SCOPUS:79952841849
SN - 0004-0010
VL - 146
SP - 256
EP - 261
JO - Archives of Surgery
JF - Archives of Surgery
IS - 3
ER -