Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3, Lok Man Road, Hong Kong SAR, China.
J Hepatobiliary Pancreat Sci. 2011 Jul;18(4):471-80. doi: 10.1007/s00534-011-0389-2.
Robotic surgery has emerged as one of the most promising surgical advances since its launch at the turn of the millennium. Despite its worldwide acceptance in many different surgical specialties, the use of robotic assistance in the field of hepatobiliary and pancreatic (HBP) surgery remains relatively unexplored. This article aims to evaluate the efficacy and outcomes of robotic HBP surgery in a single surgical center.
Between May 2009 and December 2010, all patients admitted to our unit for robotic HBP surgery were evaluated. A retrospective analysis of a prospectively maintained database on clinical outcomes was performed.
There were 55 robotic HBP operations performed during the study period. There were 27 robotic liver resections (left lateral sectionectomies n = 17, left hepatectomy n = 1, other segmentectomies n = 2 and wedge resections n = 7), 12 robotic pancreatic procedures (Whipple's operations n = 8, spleen-preserving distal pancreatectomies n = 2, double bypass n = 1 and cystojejunostomy n = 1) and 16 biliary procedures (biliary enteric bypass n = 9, bile duct exploration and related procedures n = 7). The median postoperative hospital stays for robotic liver resections, biliary procedures and pancreatic operations were 5.5 days (range 3-11 days), 6 days (range 4-11 days) and 12 days (range 6-21 days), respectively. Morbidities for liver resection, biliary procedures and pancreatic operations were 7.4, 18 and 33%, respectively. There was no mortality in our series.
Robotic surgery is feasible and can be safely performed in patients with complicated HBP pathologies. Further evaluation with clinical trials is required to validate its real benefits.
自千禧年推出以来，机器人手术已成为最有前途的手术进展之一。尽管在许多不同的外科专业领域得到了全球认可，但在肝胆胰（HBP）手术领域，机器人辅助的使用仍相对未得到探索。本文旨在评估单中心机器人 HBP 手术的疗效和结果。
在 2009 年 5 月至 2010 年 12 月期间，评估了所有在我们单位接受机器人 HBP 手术的患者。对临床结果的前瞻性维护数据库进行了回顾性分析。
在研究期间共进行了 55 例机器人 HBP 手术。其中有 27 例机器人肝切除术（左外侧叶切除术 n=17、左半肝切除术 n=1、其他节段切除术 n=2 和楔形切除术 n=7）、12 例机器人胰腺手术（胰十二指肠切除术 n=8、保留脾脏的胰体尾切除术 n=2、双旁路术 n=1 和胆肠吻合术 n=1）和 16 例胆道手术（胆肠旁路术 n=9、胆管探查及相关手术 n=7）。机器人肝切除术、胆道手术和胰腺手术的中位术后住院时间分别为 5.5 天（范围 3-11 天）、6 天（范围 4-11 天）和 12 天（范围 6-21 天）。肝切除术、胆道手术和胰腺手术的发病率分别为 7.4%、18%和 33%。本系列无死亡病例。
机器人手术是可行的，可安全用于治疗复杂的 HBP 病变。需要进行临床试验进一步评估以验证其真正的益处。
