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Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
Published on: January 3, 2020
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Oncologic multivisceral resections involving the pancreas
Artur Rebelo1, Bodil Andersson2,3, Samik Kumar Bandyopadhyay4
1Department of Visceral, Vascular and Endocrine Surgery, University Hospital Halle (Saale), Martin-Luther-University Halle-Wittenberg, Halle, Germany.
International Journal of Surgery (London, England)
|December 19, 2025
Summary
Multivisceral pancreatic resections carry significant perioperative risk. Patient selection, minimally invasive approaches, and high-volume centers can improve outcomes for these complex oncologic surgeries.
Area of Science:
- Surgical Oncology
- Gastrointestinal Surgery
- Pancreatic Surgery
Background:
- Multivisceral resections involving the pancreas are necessary for advanced abdominal cancers.
- These complex procedures carry substantial perioperative risks.
- Limited large-scale international data exist for risk stratification and surgical decision-making.
Purpose of the Study:
- To evaluate short-term outcomes of multivisceral pancreatic resections.
- To identify predictors of morbidity and mortality in these patients.
Main Methods:
- Retrospective cohort study of 1,283 patients from 31 international centers.
- Analysis of patient demographics, tumor characteristics, operative details, and 90-day postoperative outcomes.
Main Results:
- 90-day mortality was 6.9%, with higher rates for gastric adenocarcinoma.
- Major complications (Clavien-Dindo grade III-V) occurred in 34.4% of patients.
- Predictors of increased risk included higher ASA classification and open surgery; female gender and high-volume centers were protective.
Conclusions:
- Multivisceral pancreatic resections involve significant perioperative risk.
- Optimizing patient selection and utilizing minimally invasive techniques are crucial.
- Centralizing care at high-volume centers may enhance outcomes for these complex procedures.

