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Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
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Robot-Assisted Middle Pancreatectomy for Elderly Patients: Our Initial Experience
Tian Zhang1, Xinjing Wang1, Zhen Huo1
1Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
Summary
Robot-assisted middle pancreatectomy is safe and feasible for elderly patients, showing good long-term outcomes with a low risk of endocrine or exocrine dysfunction. Careful management minimizes complications like postoperative pancreatic fistula (POPF).
Area of Science:
- Surgical Oncology
- Robotic Surgery
- Geriatric Surgery
Background:
- Elderly patients undergoing pancreatic surgery present unique challenges.
- Robot-assisted surgery offers potential benefits in complex procedures.
Purpose of the Study:
- Evaluate the safety and feasibility of robot-assisted middle pancreatectomy (MP) in elderly patients.
- Assess short- and long-term outcomes, including functional and oncologic results.
Main Methods:
- Retrospective analysis of 10 patients (≥60 years) who underwent robot-assisted MP between 2012 and 2015.
- Analysis of perioperative data, including operating time, blood loss, and postoperative pancreatic fistula (POPF) rates.
- Follow-up data collection for functional outcomes and tumor recurrence.
Main Results:
- The mean patient age was 64.3 years; average tumor size was 2.61 cm, with all lesions being benign or low-grade malignant.
- Mean operating time was 175 minutes with minimal blood loss (113 ml), requiring no transfusions.
- Postoperative pancreatic fistula (POPF) occurred in 50% of patients (2 Grade A, 3 Grade B), with 3 patients experiencing other complications (1 Grade 3). No reoperations or mortality occurred.
Conclusions:
- Robot-assisted middle pancreatectomy (MP) is a safe and feasible option for elderly patients.
- The procedure demonstrated a low risk of new or worsened endocrine/exocrine dysfunction and positive long-term outcomes.
- While POPF incidence was notable, effective perioperative care mitigated adverse outcomes.
