An end-to-end pancreatic anastomosis in robotic central pancreatectomy
Abstract Background Suturing the proximal pancreatic stump and performing pancreaticoenterostomy for the distal pancreatic stump following central pancreatectomy is a conventional procedure. This reconstruction after resection of the pathological pancreatic lesion brings changes in anatomy and physi...
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| Format: | Article |
| Language: | English |
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BMC
2019-04-01
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| Series: | World Journal of Surgical Oncology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12957-019-1609-5 |
| _version_ | 1819162173482467328 |
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| author | Zi-Zheng Wang Guo-Dong Zhao Zhi-Ming Zhao Yuan-Xing Gao Yong Xu Zhu-Zeng Yin Qu Liu Wan Yee Lau Rong Liu |
| author_facet | Zi-Zheng Wang Guo-Dong Zhao Zhi-Ming Zhao Yuan-Xing Gao Yong Xu Zhu-Zeng Yin Qu Liu Wan Yee Lau Rong Liu |
| author_sort | Zi-Zheng Wang |
| collection | DOAJ |
| description | Abstract Background Suturing the proximal pancreatic stump and performing pancreaticoenterostomy for the distal pancreatic stump following central pancreatectomy is a conventional procedure. This reconstruction after resection of the pathological pancreatic lesion brings changes in anatomy and physiology. In this study, an innovative one-stage robotic end-to-end pancreatic anastomosis was reported to replace the conventional pancreaticoenterostomy following central pancreatectomy. Materials and methods The clinical data of 11 consecutive patients who underwent robotic central pancreatectomy with end-to-end pancreatic anastomosis between August 2017 and December 2017 were analyzed retrospectively. Results All operations were completed successfully without any conversion to open surgery. Nine patients had benign tumors, one had a mass-forming chronic pancreatitis, and one had an isolated pancreatic metastasis from a renal cancer. The mean gap left after central pancreatectomy was 4.3 ± 1.0 cm. The median operative time was 121 (range, 105 to 199) min. The median blood loss was 50 (range, 20 to 100) ml. Seven (63.6%) patients developed complications which included Clavien–Dindo Grade I complications in five patients, a Grade II complication in one patient, and a Grade IIIa complication in one patient. Seven patients developed a Grade B postoperative pancreatic fistula, and two patients a biochemical leak. There was no Grade C or worse pancreatic fistula. Magnetic resonance cholangiopancreatography at postoperative 6 months showed no stricture in any of the main pancreatic ducts. Three patients had an asymptomatic and small pancreatic pseudocyst. Conclusion Robotic central pancreatectomy with end-to-end pancreatic anastomosis was safe and feasible. It restores the normal anatomy of the pancreas. With its good short-and long-term outcomes, it could be an alternative reconstructive method to pancreaticoenterostomy following central pancreatectomy. |
| first_indexed | 2024-12-22T17:24:02Z |
| format | Article |
| id | doaj.art-3dbb43e36cec43eaa9810db3fa73f4a7 |
| institution | Directory Open Access Journal |
| issn | 1477-7819 |
| language | English |
| last_indexed | 2024-12-22T17:24:02Z |
| publishDate | 2019-04-01 |
| publisher | BMC |
| record_format | Article |
| series | World Journal of Surgical Oncology |
| spelling | doaj.art-3dbb43e36cec43eaa9810db3fa73f4a72022-12-21T18:18:46ZengBMCWorld Journal of Surgical Oncology1477-78192019-04-011711810.1186/s12957-019-1609-5An end-to-end pancreatic anastomosis in robotic central pancreatectomyZi-Zheng Wang0Guo-Dong Zhao1Zhi-Ming Zhao2Yuan-Xing Gao3Yong Xu4Zhu-Zeng Yin5Qu Liu6Wan Yee Lau7Rong Liu8Second Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalFaculty of Medicine, The Chinese University of Hong Kong, Prince of Wales HospitalSecond Department of Hepatopancreatobiliary Surgery, Chinese People’s Liberation Army (PLA) General HospitalAbstract Background Suturing the proximal pancreatic stump and performing pancreaticoenterostomy for the distal pancreatic stump following central pancreatectomy is a conventional procedure. This reconstruction after resection of the pathological pancreatic lesion brings changes in anatomy and physiology. In this study, an innovative one-stage robotic end-to-end pancreatic anastomosis was reported to replace the conventional pancreaticoenterostomy following central pancreatectomy. Materials and methods The clinical data of 11 consecutive patients who underwent robotic central pancreatectomy with end-to-end pancreatic anastomosis between August 2017 and December 2017 were analyzed retrospectively. Results All operations were completed successfully without any conversion to open surgery. Nine patients had benign tumors, one had a mass-forming chronic pancreatitis, and one had an isolated pancreatic metastasis from a renal cancer. The mean gap left after central pancreatectomy was 4.3 ± 1.0 cm. The median operative time was 121 (range, 105 to 199) min. The median blood loss was 50 (range, 20 to 100) ml. Seven (63.6%) patients developed complications which included Clavien–Dindo Grade I complications in five patients, a Grade II complication in one patient, and a Grade IIIa complication in one patient. Seven patients developed a Grade B postoperative pancreatic fistula, and two patients a biochemical leak. There was no Grade C or worse pancreatic fistula. Magnetic resonance cholangiopancreatography at postoperative 6 months showed no stricture in any of the main pancreatic ducts. Three patients had an asymptomatic and small pancreatic pseudocyst. Conclusion Robotic central pancreatectomy with end-to-end pancreatic anastomosis was safe and feasible. It restores the normal anatomy of the pancreas. With its good short-and long-term outcomes, it could be an alternative reconstructive method to pancreaticoenterostomy following central pancreatectomy.http://link.springer.com/article/10.1186/s12957-019-1609-5Robotic surgeryCentral pancreatectomyEnd-to-end pancreatic anastomosis |
| spellingShingle | Zi-Zheng Wang Guo-Dong Zhao Zhi-Ming Zhao Yuan-Xing Gao Yong Xu Zhu-Zeng Yin Qu Liu Wan Yee Lau Rong Liu An end-to-end pancreatic anastomosis in robotic central pancreatectomy World Journal of Surgical Oncology Robotic surgery Central pancreatectomy End-to-end pancreatic anastomosis |
| title | An end-to-end pancreatic anastomosis in robotic central pancreatectomy |
| title_full | An end-to-end pancreatic anastomosis in robotic central pancreatectomy |
| title_fullStr | An end-to-end pancreatic anastomosis in robotic central pancreatectomy |
| title_full_unstemmed | An end-to-end pancreatic anastomosis in robotic central pancreatectomy |
| title_short | An end-to-end pancreatic anastomosis in robotic central pancreatectomy |
| title_sort | end to end pancreatic anastomosis in robotic central pancreatectomy |
| topic | Robotic surgery Central pancreatectomy End-to-end pancreatic anastomosis |
| url | http://link.springer.com/article/10.1186/s12957-019-1609-5 |
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