Do pre-operative endoscopic procedures, impact the surgical outcomes of robotic pancreaticoduodenectomy?
Humans
Pancreaticoduodenectomy
/ methods
Robotic Surgical Procedures
/ methods
Male
Female
Middle Aged
Aged
Retrospective Studies
Treatment Outcome
Preoperative Care
/ methods
Cholangiopancreatography, Endoscopic Retrograde
/ methods
Endoscopic Ultrasound-Guided Fine Needle Aspiration
/ methods
Pancreatic Neoplasms
/ surgery
Endoscopic retrograde cholangiopancreatography (ERCP)
Endoscopic ultrasound with fine needle aspiration (EUS/FNA)
Perioperative complications
Pre-operative endoscopic interventions
Robotic pancreaticoduodenectomy
Surgical outcomes
Journal
Journal of robotic surgery
ISSN: 1863-2491
Titre abrégé: J Robot Surg
Pays: England
ID NLM: 101300401
Informations de publication
Date de publication:
05 Jul 2024
05 Jul 2024
Historique:
received:
09
05
2024
accepted:
29
06
2024
medline:
5
7
2024
pubmed:
5
7
2024
entrez:
5
7
2024
Statut:
epublish
Résumé
The role and risks of pre-operative endoscopic procedures, such as endoscopic retrograde cholangiopancreatography (ERCP) and endoscopic ultrasound with fine needle aspiration (EUS/FNA), in patients undergoing robotic pancreaticoduodenectomy are not well-defined despite a broad consensus on the utility of these interventions for diagnostic and therapeutic purposes prior to major pancreatic operations. This study investigates the impact of such preoperative endoscopic interventions on perioperative outcomes in robotic pancreaticoduodenectomy. With Institutional Review Board (IRB) approval we retrospectively analyzed 772 patients who underwent robotic pancreatectomies between 2012 and 2023. Specifically, 430 of these patients underwent a robotic pancreaticoduodenectomy were prospectively evaluated: 93 (22%) patients underwent ERCP with EUS and FNA, 45 (10%) ERCP only, and 31 (7%) EUS and FNA, while 261 (61%) did not. Statistical analyses were performed using chi-square tests and Student's t-tests to compare perioperative outcomes between the two cohorts. Statistically significant differences were observed in patients who underwent a pre-operative endoscopic intervention and were more likely to have converted to an open operation (p = 0.04). The average number of harvested lymph nodes for patients who underwent preoperative endoscopic intervention was statistically significant compared to those who did not (p = 0.0001). All other perioperative variables were consistent across all cohorts. Patients who underwent endoscopic intervention before robotic pancreaticoduodenectomy were more likely to have an unplanned open operation. This study demonstrates the increased operative difficulties introduced by preoperative endoscopic interventions. Although there was no impact on overall patient outcomes, surgeons' experience can minimize the associated risks.
Identifiants
pubmed: 38967695
doi: 10.1007/s11701-024-02036-z
pii: 10.1007/s11701-024-02036-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
279Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag London Ltd., part of Springer Nature.
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