Short-term results of robot-assisted pancreatoduodeodenectomy: a retrospective cohort study of 146 patients operated in a high-volume center.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
09 Jul 2024
Historique:
received: 21 01 2024
revised: 04 05 2024
accepted: 05 07 2024
medline: 1 8 2024
pubmed: 1 8 2024
entrez: 31 7 2024
Statut: aheadofprint

Résumé

Pancreaticoduodenectomy (PD) is a challenging operation because of complex anatomy and difficult and multiple reconstructions. Robot-assisted PD (RPD) is a novel minimally invasive technique, providing equivalent oncological outcomes to open surgery. The aim of this study is to evaluate the results of a single high-volume center series. Patients who underwent RPD from 2014 to 2021 in a high-volume center were included. Patient and disease-specific data, operative details, postoperative complications including postoperative pancreatic fistula (POPF), length of stay (LOS) and long-term survival were recorded. Two groups were compared: Group 1: patients operated between 2014-2019 and Group 2 between 2020-2021. One hundred and forty-six patients had RPD on the study period (99 in Group 1 and 47 in Group 2). Operative time was 320 min (285-360), major complications were observed in 28% and clinically significant POPF in 20% of the cases. Conversion rate was 2.1%. LOS was 14 days (9-22). Postoperative mortality was 4.1%. Clinically significant POPF decreased from 24% in Group 1 to 11% in Group 2 (p = 0.05). LOS decreased from 16(11-26) days in Group 1 to 11(8-14) in Group 2 (p < 0.001). RPD is safe and feasible. Technique standardization led to better post-operative outcomes, encouraging the dissemination and implementation of the procedure.

Sections du résumé

BACKGROUND BACKGROUND
Pancreaticoduodenectomy (PD) is a challenging operation because of complex anatomy and difficult and multiple reconstructions. Robot-assisted PD (RPD) is a novel minimally invasive technique, providing equivalent oncological outcomes to open surgery. The aim of this study is to evaluate the results of a single high-volume center series.
METHODS METHODS
Patients who underwent RPD from 2014 to 2021 in a high-volume center were included. Patient and disease-specific data, operative details, postoperative complications including postoperative pancreatic fistula (POPF), length of stay (LOS) and long-term survival were recorded. Two groups were compared: Group 1: patients operated between 2014-2019 and Group 2 between 2020-2021.
RESULTS RESULTS
One hundred and forty-six patients had RPD on the study period (99 in Group 1 and 47 in Group 2). Operative time was 320 min (285-360), major complications were observed in 28% and clinically significant POPF in 20% of the cases. Conversion rate was 2.1%. LOS was 14 days (9-22). Postoperative mortality was 4.1%. Clinically significant POPF decreased from 24% in Group 1 to 11% in Group 2 (p = 0.05). LOS decreased from 16(11-26) days in Group 1 to 11(8-14) in Group 2 (p < 0.001).
CONCLUSION CONCLUSIONS
RPD is safe and feasible. Technique standardization led to better post-operative outcomes, encouraging the dissemination and implementation of the procedure.

Identifiants

pubmed: 39084949
pii: S1365-182X(24)02207-X
doi: 10.1016/j.hpb.2024.07.402
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Auteurs

Abdallah Iben-Khayat (A)

Departement of Digestive and Endocrine Surgery, University Hospital of Orléans, 14 Av. de l'Hôpital, 45100, Orléans, France.

Emanuelle Felli (E)

HPB Surgery Unit, Groupe Hospitalier Saint Vincent, 29, Rue du Faubourg National, 67000, Strasbourg, France; Institute for Translational Medicine and Liver Disease, Unité 1110 INSERM, Strasbourg, France.

Baudouin Thebault (B)

Departement of Digestive and Endocrine Surgery, University Hospital of Orléans, 14 Av. de l'Hôpital, 45100, Orléans, France.

Amaury Facques (A)

Departement of Digestive and Endocrine Surgery, University Hospital of Orléans, 14 Av. de l'Hôpital, 45100, Orléans, France.

Haythem Najah (H)

Departement of Digestive and Endocrine Surgery, University Hospital of Orléans, 14 Av. de l'Hôpital, 45100, Orléans, France.

Olivier Saint-Marc (O)

Departement of Digestive and Endocrine Surgery, University Hospital of Orléans, 14 Av. de l'Hôpital, 45100, Orléans, France. Electronic address: olivier.saint-marc@chu-orleans.fr.

Classifications MeSH