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Wayne CD, Benbetka C, Besner GE, Narayanan S. Challenges of Managing Type 3c Diabetes in the Context of Pancreatic Resection, Cancer and Trauma. J Clin Med 2024; 13:2993. [PMID: 38792534 PMCID: PMC11122338 DOI: 10.3390/jcm13102993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Revised: 05/04/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
Type 3c diabetes mellitus (T3cDM), also known as pancreatogenic or pancreoprivic diabetes, is a specific type of DM that often develops as a result of diseases affecting the exocrine pancreas, exhibiting an array of hormonal and metabolic characteristics. Several pancreatic exocrine diseases and surgical procedures may cause T3cDM. Diagnosing T3cDM remains difficult as the disease characteristics frequently overlap with clinical presentations of type 1 DM (T1DM) or type 2 DM (T2DM). Managing T3cDM is likewise challenging due to numerous confounding metabolic dysfunctions, including pancreatic endocrine and exocrine insufficiencies and poor nutritional status. Treatment of pancreatic exocrine insufficiency is of paramount importance when managing patients with T3cDM. This review aims to consolidate the latest information on surgical etiologies of T3cDM, focusing on partial pancreatic resections, total pancreatectomy, pancreatic cancer and trauma.
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Affiliation(s)
- Colton D. Wayne
- Department of Pediatric Surgery, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; (C.D.W.); (G.E.B.)
- Center for Perinatal Research, Nationwide Children’s Hospital, Columbus, OH 43205, USA
- Department of Surgery, Baylor University Medical Center, 3600 Gaston Ave, Dallas, TX 75246, USA
| | | | - Gail E. Besner
- Department of Pediatric Surgery, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; (C.D.W.); (G.E.B.)
- Center for Perinatal Research, Nationwide Children’s Hospital, Columbus, OH 43205, USA
| | - Siddharth Narayanan
- Department of Pediatric Surgery, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205, USA; (C.D.W.); (G.E.B.)
- Center for Perinatal Research, Nationwide Children’s Hospital, Columbus, OH 43205, USA
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Wang ML, Shyr BS, Chen SC, Wang SE, Shyr YM, Shyr BU. Comparison of robotic and open central pancreatectomy. Int J Med Robot 2023:e2562. [PMID: 37574857 DOI: 10.1002/rcs.2562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/01/2023] [Accepted: 07/20/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Central pancreatectomy (CP) is an ideal parenchyma-sparing procedure. The experience of r robotic central pancreatectomy (RCP) is very limited. MATERIALS AND METHODS Patients undergoing CP were included. Comparisons were made between RCP and open central pancreatectomy (OCP) groups. RESULTS The most common lesion in patients undergoing CP was serous cystadenoma (35.5%). The median operation time was 4.2 h for RCP versus 5.5 h for OCP. The median blood loss was significantly lower in RCP, 20 c.c. versus 170 c.c., p = 0.001. Postoperative pancreatic fistula occurred in 19.4% of all patients, with 22.1% in RCP and 15.4% in OCP. There was no significant difference regarding other surgical complications between the RCP and OCP groups. Only one patient in the OCP group developed de novo diabetes mellitus (DM), and no steatorrhoea/diarrhoea occurred after either RCP or OCP. CONCLUSIONS RCP is feasible and safe without compromising surgical outcomes and pancreatic functions.
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Affiliation(s)
- Man-Ling Wang
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bor-Shiuan Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shih-Chin Chen
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Shin-E Wang
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Ming Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Bor-Uei Shyr
- Departments of Surgery, Division of General Surgery, Taipei Veterans General Hospital, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Liu G, Tan X, Li J, Zhong G, Zhai J, Li M. Case report: Treatment of intraductal papillary mucinous neoplasms located in middle-segment pancreas with end-to-end anastomosis reconstruction after laparoscopic central pancreatectomy surgery through a pigtail-tube-stent placement of the pancreatic duct. Front Surg 2022; 9:937682. [PMID: 36117840 PMCID: PMC9475139 DOI: 10.3389/fsurg.2022.937682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 07/25/2022] [Indexed: 12/04/2022] Open
Abstract
Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is one type of pancreatic cystic neoplasm. IPMNs can be classified into three types: main duct-IPMN (MD-IPMN), branch duct-IPMN (BD-IPMN), and mixed type-IPMN (MT-IPMN). It is universally accepted by most surgeons that patients who suffered from MD-IPMN with a high risk of malignant transformation should undergo surgical resection. However, a consensus on the best surgical strategy for MD-IPMN located in the pancreatic neck has still eluded the surgical community worldwide. Recently, one patient suffering from this condition in our Minimally Invasive Pancreas Center underwent a successful surgical procedure. In this case report, we performed a laparoscopic central pancreatectomy for this patient. During this surgical procedure, we used a method of end-to-end anastomosis reconstruction through a pigtail-tube-stent placement of the pancreatic duct. Before the construction of the remnant pancreas, the surgical margins of the frozen section should be negative. After surgery, the outcome of this case was satisfactory. No complications such as postoperative hemorrhage, abdominal infection, pancreatitis, delayed gastric emptying, and clinically relevant postoperative pancreatic fistula occurred, which demonstrated that this surgical strategy could achieve a good clinical therapeutic effect for the pancreatic neck MD-IPMN. The result of postoperative routine pathology confirmed the diagnosis of MD-IPMN. The pathological features also showed that there was a high degree of hyperplasia in the local epithelium, which indicated the necessity of surgical treatment.
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Kvashilava A, Kobalava B, Giorgobiani G. Laparoscopic Central Pancreatectomy With Pancreaticogastrostomy: Our Initial Experience. Cureus 2022; 14:e24542. [PMID: 35651384 PMCID: PMC9138204 DOI: 10.7759/cureus.24542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2022] [Indexed: 11/15/2022] Open
Abstract
Pancreatic parenchyma-preserving procedures performed for benign and low-grade malignant tumors of the neck or body of this organ significantly reduce the incidence of postoperative exocrine and endocrine insufficiency compared to distal pancreatectomy. Tumor enucleation spares pancreatic parenchyma, but it can have positive surgical margins, and postoperative leakage after it is significant. We present our initial successful experience of laparoscopic central pancreatectomy. A patient was operated on for cystadenoma of the pancreatic neck. The organ was transected proximally with a linear stapler but distally with ultrasonic shares, and a caudal stump was used for the creation of the pancreaticogastrostomy. The postoperative period was uneventful. The four-month follow-up did not reveal any exocrine or endocrine insufficiency.
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Affiliation(s)
| | - Badri Kobalava
- General Surgery, Aversi Clinic, Tbilisi, GEO
- Surgery Department #3, Faculty of Medicine, Tbilisi State Medical University, Tbilsi, GEO
| | - Giorgi Giorgobiani
- General Surgery, Aversi Clinic, Tbilisi, GEO
- Surgery Department #3, Faculty of Medicine, Tbilisi State Medial University, Tbilisi, GEO
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5
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Khachfe HH, Habib JR, Harthi SA, Suhool A, Hallal AH, Jamali FR. Robotic pancreas surgery: an overview of history and update on technique, outcomes, and financials. J Robot Surg 2021; 16:483-494. [PMID: 34357526 DOI: 10.1007/s11701-021-01289-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/31/2021] [Indexed: 02/06/2023]
Abstract
The use robotics in surgery is gaining momentum. This approach holds substantial promise in pancreas surgery. Robotic surgery for pancreatic lesions and malignancies has become well accepted and is expanding to more and more center annually. The number of centers using robotics in pancreatic surgery is rapidly increasing. The most studied robotic pancreas surgeries are pancreaticoduodenectomy and distal pancreatectomy. Most studies are in their early phases, but they report that robotic pancreas surgery is safe feasible. Robotic pancreas surgery offers several advantages over open and laparoscopic techniques. Data regarding costs of robotics versus conventional techniques is still lacking. Robotic pancreas surgery is still in its early stages. It holds promise to become the new surgical standard for pancreatic resections in the future, however, more research is still needed to establish its safety, cost effectiveness and efficacy in providing the best outcomes.
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Affiliation(s)
- Hussein H Khachfe
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. .,Division of GI Surgical Oncology, Department of Surgery, UPMC Pancreatic Cancer Center, University of Pittsburgh Medical Center, UPMC Cancer Pavilion, Pittsburgh, PA, USA.
| | - Joseph R Habib
- Division of General Surgery, Johns Hopkins University, Baltimore, Maryland, USA
| | - Salem Al Harthi
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Amal Suhool
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Ali H Hallal
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
| | - Faek R Jamali
- Department of Surgery, Sheikh Shakhbout Medical City, Abu Dhabi, UAE
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P SK, Harikrishnan S, Satyanesan J. Central Pancreatectomy for Central Pancreatic Lesions: A Single-Institution Experience. Cureus 2021; 13:e16108. [PMID: 34350075 PMCID: PMC8325928 DOI: 10.7759/cureus.16108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2021] [Indexed: 01/02/2023] Open
Abstract
Background Pancreaticoduodenectomy and distal pancreatectomy are radical procedures for pancreatic lesions with high postoperative morbidity and mortality even in experienced hands. Central pancreatectomy is an alternative less radical procedure for centrally located pancreatic lesions that are benign or have a low malignant potential. It involves removing the central portion of the pancreas and has the advantage of preserving the pancreatic parenchyma, thereby decreasing the postoperative endocrine and exocrine insufficiencies. Methods We conducted a prospective study of six cases of central pancreatectomy in the Department of Surgical Gastroenterology and Liver Transplant, Government Stanley Medical College, India, between the years 2015 and 2019. All patients with lesions in the neck and proximal body of the pancreas were clinically and radiologically evaluated, and those with benign or borderline malignant lesions underwent central pancreatectomy by a standardized technique. Results The mean age of the patients was 27.8 years (range: 14 years - 37 years). Most of the patients were females (66.6%). The most common presenting symptom was abdominal pain, and the most common diagnosis was solid pseudopapillary neoplasm (83.3%). The mean diameter of the lesion was 6.1 cm. All patients underwent pancreaticojejunostomy of the distal stump. The median operative time and the blood loss were 310 minutes and 85 ml, respectively. Two patients developed biochemical postoperative pancreatic fistula, and in the long-term follow-up, none of them developed endocrine or exocrine insufficiency. Conclusion Central pancreatectomy is a safe and effective alternative for benign and low-grade lesions in the neck and body of the pancreas in which the head of the pancreas and a significant portion of the distal body and tail of the pancreas is uninvolved. Standardization of this pancreas-preserving procedure will result in better outcomes.
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Affiliation(s)
- Senthil Kumar P
- Surgical Gastroenterology and Liver Transplant, Government Stanley Medical College, Chennai, IND
| | - Sakthivel Harikrishnan
- Surgical Gastroenterology and Liver Transplant, Government Stanley Medical College, Chennai, IND
| | - Jeswanth Satyanesan
- Surgical Gastroenterology and Liver Transplant, Government Stanley Medical College, Chennai, IND
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Wang ZZ, Zhao GD, Zhao ZM, Hu MG, Tan XL, Zhang X, Gao YX, Liu R. A comparative study of end-to-end pancreatic anastomosis versus pancreaticojejunostomy after robotic central pancreatectomy. Updates Surg 2021; 73:967-975. [PMID: 33797734 DOI: 10.1007/s13304-021-01037-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 03/22/2021] [Indexed: 10/21/2022]
Abstract
Robotic central pancreatectomy has been applied for 20 years with the advantage of minimally invasive surgery. The general pancreatic reconstruction approaches include pancreaticojejunostomy and pancreaticogastrostomy. Recently, our group reported a few preliminary cases of application of end-to-end pancreatic anastomosis in robotic central pancreatectomy. This novel approach has not been compared with the conventional approach on a large scale. The objective of this study is to compare end-to-end pancreatic anastomosis with pancreaticojejunostomy after robotic central pancreatectomy based on the perioperative and long-term outcomes. Clinical data consist of demographics, clinicopathologic characteristics, perioperative and long-term outcomes of patients who underwent robotic central pancreatectomy from March 2015 to December 2019 were collected and analyzed. Seventy-four patients received a robotic central pancreatectomy with either end-to-end pancreatic anastomosis (n = 52) or pancreaticojejunostomy (n = 22). End-to-end pancreatic anastomosis was associated with shorter operative time and reduced blood loss. Despite a higher incidence of clinically relevant postoperative pancreatic fistula (69.2% vs. 36.4%, p = 0.009), the newer anastomotic technique was also associated with earlier removal of nasogastric tube and resumption of oral intake. Long-term results, in terms of either endocrine or exocrine function, were not affected by the anastomotic technique. We have shown the feasibility of robotic central pancreatectomy with end-to-end pancreatic anastomosis. Despite streamlined technique, the newer anastomosis appears to improve early post-operative results while preserving endocrine and exocrine functions in the long-term period. Evaluation of the true potential of robotic central pancreatectomy with end-to-end pancreatic anastomosis requires a prospective and randomized study enrolling a large number of patients.
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Affiliation(s)
- Zi-Zheng Wang
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Guo-Dong Zhao
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Zhi-Ming Zhao
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ming-Gen Hu
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xiang-Long Tan
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Xuan Zhang
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Yuan-Xing Gao
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Rong Liu
- Faculty of Hepato-Pancreato-Biliary Surgery, Institute of Hepatobiliary Surgery of Chinese PLA, Key Laboratory of Digital Hepetobiliary Surgery of Chinese PLA, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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Huynh F, Cruz CJ, Hwang HK, Lee WJ, Kang CM. Minimally invasive (laparoscopic and robot-assisted) versus open approach for central pancreatectomies: a single-center experience. Surg Endosc 2021; 36:1326-1331. [PMID: 33661383 DOI: 10.1007/s00464-021-08409-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 02/15/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND There continues to be an interest in minimally invasive approaches to pancreatic surgery. At our institution, there has been a progressive change from an open to minimally invasive surgery (MIS) (laparoscopic, robotic, or laparoscopic-robotic) approach for central pancreatectomies (CP). The aim of this study was to evaluate surgical outcomes with open CP (O-CP) versus minimally invasive CP (MI-CP). METHODS A retrospective medical review of patients who underwent CP between 1993 and 2018 at Yonsei University Health System, Seoul, Korea was performed. Short-term perioperative outcomes were compared between O-CP and MI-CP. RESULTS Thirty-one CPs (11 open, 20 MIS) were identified during the study period. No difference was observed in admission days between O-CP and MI-CP (21.2 vs. 16.7 days, p = 0.340), although operating time was significantly increased in the MI-CP group (296.8 vs. 374.8 min, p = 0.036). Blood loss was significantly less in MI-CP vs. O-CP (807.1 vs. 214.0 mls, p = 0.001), with no difference in post-operative new-onset diabetes (9% vs. 5%). The overall post-operative pancreatic fistula rate was 25.8%, and no significant difference between O-CP and MI-CP or complication rates (45% vs. 40%) was observed. CONCLUSION Despite increased operative time, MI-CP is feasible and comparable to conventional O-CP with regard to surgical outcomes in well-selected patients.
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Affiliation(s)
- Frederick Huynh
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
- HepatoPancreatoBiliary (HPB) Service, Alfred Health, Melbourne, VIC, Australia
| | - Charles Jimenez Cruz
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
- Liver and Pancreas Center, Department of Surgery, The Medical City Clark, Mabalacat, Philippines
- Centro Medico De Santisimo Rosario Hospital, Balanga City, Philippines
| | - Ho Kyoung Hwang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Woo Jung Lee
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea
| | - Chang Moo Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Yonsei University College of Medicine, Ludlow Faculty Research Building #201, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, Korea.
- Pancreatobiliary Cancer Center, Yonsei Cancer Center, Severance Hospital, Seoul, Korea.
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Ku G, Kang I, Lee WJ, Kang CM. Revo-i assisted robotic central pancreatectomy. Ann Hepatobiliary Pancreat Surg 2020; 24:547-550. [PMID: 33234762 PMCID: PMC7691199 DOI: 10.14701/ahbps.2020.24.4.547] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Revised: 06/16/2020] [Accepted: 06/17/2020] [Indexed: 11/25/2022] Open
Abstract
Central pncreatectomy (CP) can be one of procedures for function-preserving pancreatectomy for patients with benign or low grade malignant pancreatic tumors. Surgeons have to deal with two cut surface of the pancreas when performing CP, which can be associated with severe complication, such as postoperative pancreatic fistula. Fine and delicate surgical skill is highly required for safe CP. With the advance of minimally invasive surgery, CP is now thought to be one of appropriate procedures for function-preserving minimally invasive pancreatectomy. Robotic surgery is thought to make complicated surgical procedure easy and effective. Recently, Korean robotic surgical system, Revo-i, was successfully developed by Meeraecompany and have been proved its safety and feasibility in several recent reports. A 56-year old woman was referred for a body of pancreatic lesion. Contrast abdominopelvic CT revealed a pancreatic body tumor measuring around 1.2 cm in diameter. The patient underwent a robot-assisted central pancreatectomy using Revo-i. The patient endured the procedure well and was discharged to home at postoperative day 9. This report showed a successful case of central pancreatectomy performed with the Korean robotic surgical system Revo-i.
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Affiliation(s)
- Gayoon Ku
- Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea
| | - Incheon Kang
- Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Woo Jung Lee
- Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Center, Yonsei Cancer Center Severance Hospital, Seoul, Korea
| | - Chang Moo Kang
- Division of HBP Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.,Pancreatobiliary Cancer Center, Yonsei Cancer Center Severance Hospital, Seoul, Korea
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Update on Robotic Pancreatic Surgery. CURRENT SURGERY REPORTS 2020. [DOI: 10.1007/s40137-020-00269-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sidler M, Shah P, Ashworth M, De Coppi P. Laparoscopic resection of pancreatic neck lesion with Roux-en-Y pancreatico-jejunostomy. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2019. [DOI: 10.1016/j.epsc.2018.10.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Felder SI, Ramanathan R, Russo AE, Jimenez-Rodriguez RM, Hogg ME, Zureikat AH, Strong VE, Zeh HJ, Weiser MR. Robotic gastrointestinal surgery. Curr Probl Surg 2018; 55:198-246. [PMID: 30470267 DOI: 10.1067/j.cpsurg.2018.07.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 07/26/2018] [Indexed: 12/11/2022]
Affiliation(s)
- Seth I Felder
- Department of Gastrointestinal Surgery, Moffitt Cancer Center, Tampa, Florida
| | - Rajesh Ramanathan
- Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Ashley E Russo
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | | | - Melissa E Hogg
- Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Amer H Zureikat
- Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Vivian E Strong
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Herbert J Zeh
- Division of Surgical Oncology, University of Pittsburgh Medical Center, Pittsburgh, PA
| | - Martin R Weiser
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
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Safety and efficacy for robot-assisted versus open pancreaticoduodenectomy and distal pancreatectomy: A systematic review and meta-analysis. Surg Oncol 2018; 27:468-478. [PMID: 30217304 DOI: 10.1016/j.suronc.2018.06.001] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 05/13/2018] [Accepted: 06/02/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND This meta-analysis was conducted to compare the clinical safety and efficacy of robot-assisted pancreaticoduodenectomy (RAPD) or robot-assisted distal pancreatectomy (RADP) with open surgery. METHODS Multiple databases (PubMed, Medline, EMBASE and Cochrane Library) were searched to identify studies comparing the outcomes of RAPD and open pancreaticoduodenectomy (OPD) or RADP and open distal pancreatectomy (ODP) (up to December 31, 2017). Fixed and random effects models were applied according to different conditions. RESULTS Fifteen non-randomized controlled trials (11 RAPD vs. OPD and 4 RADP vs. ODP) involving 3690 patients were included. Robot-assisted surgery had longer operative time (RAPD vs. OPD: P = 0.0005; RADP vs. ODP: P < 0.00001) but lesser blood loss than open surgery (RAPD vs. OPD: P = 0.0009; RADP vs. ODP: P = 0.0007). RAPD was associated with less wound infection, a lower positive margin rate, lower overall complications, and faster postoperative off-bed activity. There was no significant difference in the lymph node yield, the rate of pancreatic fistula, delayed gastric emptying, reoperation, length of hospital stay and mortality between the two groups. Compared with ODP, RADP was associated with less blood transfusion, fewer lymph nodes harvested, lower complications and shorter hospital stay. There was no significant difference between the two groups in the rate of spleen preservation, positive margin, pancreatic fistula, and mortality. CONCLUSIONS Robot-assisted surgery is a safe and feasible alternative to OPD and ODP with regard to perioperative outcomes. However, due to the lack of high-quality randomized controlled trials, the evidence is still limited.
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Jimenez-Rodriguez RM, Weiser MR. In Brief. Curr Probl Surg 2018. [DOI: 10.1067/j.cpsurg.2018.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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