Objective To examine feasibility and safety of robotic pancreatectomy with vascular resection and reconstruction in patients with locally advanced pancreatic cancer. Methods The authors evaluated 59 patients who underwent pancreatectomy with vascular resection and reconstruction from August 2011 to September 2017 dividing into robotic pancreatic surgery group (n=20) and open pancreatic surgery group (n=39) retrospectively. Pancreatic ductal adenocarcinoma was diagnosed 53 cases pathologically and intraductal papillary mucinous cancer 6 cases. The patients were all locally advanced pancreatic cancer including 53 cases in stage Ⅱ and 6 cases in stage Ⅲ. Intraoperative data and postoperative recovery in two groups were compared. Results Mean operative time in robotic pancreatic surgery group was (328.9±17.8) min. Mean blood loss was(568.4±72.6) mL. Grade B/C pancreatic fistula was found in 4 cases, biliary leak in 1 case and postoperative hemorrhage in 4 cases of whom 3 cases were re-operated. Mean postoperative hospital stay was (28.8±5.7) d. Mean operating time in open pancreatic surgery group was(358.5±17.2) min. Mean blood loss was (801.3±113.2) mL. Grade B/C pancreatic fistula was found in 12 cases, biliary leak in 5 cases and postoperative hemorrhage in 4 cases of whom 3 cases were re-operated. Mean postoperative hospital stay was (31.3±5.1) d. The patients of two groups were all recovered after postoperative treatment and discharged without mortalily. The mean blood loss was less （P=0.032） and the postoperative hospital stay was shorter （P=0.011）in robotic pancreatic surgery group when compared those in open pancreatic surgery group, respectively. Conclusions Robotic pancreatectomy with vascular resection and reconstruction was safe and feasible.
ZHAO Shulin, SHEN Baiyong, DENG Xiaxing, ZHAN Xi, WANG Wei, SHI Yuan, WENG Yuanchi, SUN Changjie, PENG Chenghong
. Robotic pancreatectomy with vascular resection and reconstruction of locally advanced pancreatic cancer[J]. Journal of Surgery Concepts & Practice, 2018
, 23(04)
: 352
-357
.
DOI: 10.16139/j.1007-9610.2018.04.016
[1] 陈万青, 李贺, 孙可欣, 等. 2014年中国恶性肿瘤发病和死亡分析[J]. 中华肿瘤杂志,2018,40(1):5-13.
[2] Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11[EB/OL]. Lyon, France: International Agency for Research on Cancer,2013.[2018-3-9]. http://globocan.iarc.fr.
[3] Loveček M, Skalicky P, Klos D, et al.Surgical therapy of pancreatic cancer-5 years survival[J]. Rozhl Chir,2015, 94(11):470-476.
[4] Yamamoto T, Yagi S, Kinoshita H, et al.Long-term survival after resection of pancreatic cancer: a single-center retrospective analysis[J]. World J Gastroenterol,2015,21(1):262-268.
[5] Miyazaki M, Yoshitomi H, Shimizu H, et al.Repeat pancreatectomy for pancreatic ductal cancer recurrence in the remnant pancreas after initial pancreatectomy: is it worthwhile?[J]. Surgery,2014,155(1):58-66.
[6] Bockhorn M, Uzunoglu FG, Adham M, et al.Borderline resectable pancreaticcancer: a consensus statement by the International Study Group of Pancreatic Surgery (ISGPS)[J]. Surgery,2014,155(6):977-988.
[7] Giulianotti PC, Addeo P, Buchs NC, et al.Robotic extended pancreatectomy with vascular resection for locally advanced pancreatic tumors[J]. Pancreas,2011,40(8):1264-1270.
[8] Bassi C, Marchegiani G, Dervenis C, et al.The 2016 update of the International Study Group (ISGPS) definition and grading of postoperative pancreatic fistula: 11 years after[J]. Surgery,2017,161(3):584-591.
[9] Moore GE, Sako Y, Thomas LB.Radical pancreatoduodenectomy with resection and reanastomosis of the su-perior mesenteric vein[J]. Surgery,1951,30(3):550-553.
[10] Palanivelu C, Rajan PS, Rangarajan M, et al.Evolution in techniques of laparoscopic pancreaticoduodenectomy: A decade long experience from a tertiary center[J]. J Hepatobiliary Pancreat Surg,2009,16(6):731-740
[11] Kendrick ML, Cusati D.Total laparoscopic pancreaticoduodenectomy: Feasibility and outcome in an early experience[J]. Arch Surg,2010,145(1):19-23.
[12] Aosasa S, Nishikawa M, Noro T, et al.Total pancreatectomy with celiac axis resection and hepatic artery restoration using splenic artery autograft interposition[J]. J Gastrointest Surg,2016,20(3):644-647.
[13] Giulianotti PC, Sbrana F, Bianco FM, et al.Robot-assis-ted laparoscopic pancreatic surgery: single-surgeon experience[J]. Surg Endosc,2010,24(7):1646-1657.
[14] Kauffmann EF, Napoli N, Menonna F, et al.Robotic pancreatoduodenectomy with vascular resection[J]. Langenbecks Arch Surg,2016,401(8):1111-1122.
