Ito Masahiro, Asano Yukio, Shimizu Tomohiro, Uyama Ichiro, Horiguchi Akihiko
Hepatogastroenterology. 2014 Mar-Apr;61(130):493-6.
BACKGROUND/AIMS: Minimally invasive procedures for pancreatic pathologies are increasingly being used, including distal pancreatectomy. This study aimed to assess the indications for and outcomes of the da Vinci distal pancreatectomy procedure.
We reviewed the medical records of patients who underwent pancreatic head resection from April 2009 to September 2013. Four patients (mean age, 52.7 years) underwent da Vinci distal pancreatectomy and 10 (mean age, 68.0 +/- 12.1 years) underwent laparoscopic distal pancreatectomy.
The mean surgical duration was 292 +/- 153 min and 306 +/- 29 min, the mean blood loss was 153 +/- 71 mL and 61.7 +/- 72 mL, and the mean postoperative length of stay was 24 +/- 11 days and 14 +/- 3 days in the da Vinci distal pancreatectomy and laparoscopic distal pancreatectomy groups, respectively. One patient who underwent da Vinci distal pancreatectomy developed a pancreatic fistula, while 2 patients in the laparoscopic distal pancreatectomy group developed splenic ischemia and gastric torsion, respectively.
Laparoscopic and robotic pancreatic resection were both safe and feasible in selected patients with distal pancreatic pathologies. Further studies are necessary to clarify the role of robotic surgery in the advanced laparoscopic era.
背景/目的：包括胰体尾切除术在内的胰腺疾病微创治疗方法正越来越多地被采用。本研究旨在评估达芬奇机器人胰体尾切除术的适应证及手术效果。
我们回顾了2009年4月至2013年9月期间接受胰头切除术患者的病历。4例患者（平均年龄52.7岁）接受了达芬奇机器人胰体尾切除术，10例患者（平均年龄68.0±12.1岁）接受了腹腔镜胰体尾切除术。
达芬奇机器人胰体尾切除术组和腹腔镜胰体尾切除术组的平均手术时间分别为292±153分钟和306±29分钟，平均失血量分别为153±71毫升和61.7±72毫升，平均术后住院时间分别为24±11天和14±3天。1例接受达芬奇机器人胰体尾切除术的患者发生了胰瘘，而腹腔镜胰体尾切除术组分别有2例患者发生了脾缺血和胃扭转。
对于部分胰体尾疾病患者，腹腔镜和机器人胰腺切除术均安全可行。在先进的腹腔镜时代，有必要进一步研究以明确机器人手术的作用。
