Kirks Russell C, Lorimer Patrick D, Fruscione Michael, Cochran Allyson, Baker Erin H, Iannitti David A, Vrochides Dionisios, Martinie John B
Division of Hepatopancreatobiliary Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
Division of Surgical Oncology, Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina, USA.
Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1832. Epub 2017 May 26.
This study compares clinical and cost outcomes of robot-assisted laparoscopic (RAL) and open longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis.
Clinical and cost data were retrospectively compared between open and RAL LPJ performed at a single center from 2008-2015.
Twenty-six patients underwent LPJ: 19 open and 7 RAL. Two robot-assisted cases converted to open were included in the open group for analysis. Patients undergoing RAL LPJ had less intraoperative blood loss, a shorter surgical length of stay, and lower medication costs. Operation supply cost was higher in the RAL group. No difference in hospitalization cost was found.
Versus the open approach, RAL LPJ performed for chronic pancreatitis shortens hospitalization and reduces medication costs; hospitalization costs are equivalent. A higher operative cost for RAL LPJ is mitigated by a shorter hospitalization. Decreased morbidity and healthcare resource economy support use of the robotic approach for LPJ when appropriate.
本研究比较了机器人辅助腹腔镜下（RAL）与开放纵向胰空肠吻合术（LPJ）治疗慢性胰腺炎的临床及成本效益。
回顾性比较了2008年至2015年在单一中心进行的开放手术和RAL LPJ的临床及成本数据。
26例患者接受了LPJ手术：19例为开放手术，7例为RAL手术。2例由机器人辅助转为开放手术的病例纳入开放手术组进行分析。接受RAL LPJ手术的患者术中失血量更少，手术住院时间更短，药物成本更低。RAL组的手术耗材成本更高。住院费用无差异。
与开放手术相比，RAL LPJ治疗慢性胰腺炎可缩短住院时间并降低药物成本；住院费用相当。RAL LPJ较高的手术成本因住院时间缩短而得到缓解。发病率降低和医疗资源节约支持在适当情况下使用机器人手术进行LPJ。
