Sola Richard, Kirks Russell C, Iannitti David A, Vrochides Dionisios, Martinie John B
Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
Division of Hepato-Pancreato-Biliary Surgery, Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
J Vis Surg. 2016 Jul 26;2:126. doi: 10.21037/jovs.2016.07.06. eCollection 2016.
Pancreaticoduodenectomy (PD) is considered one of the most complex and technically challenging abdominal surgeries performed by general surgeons. With increasing use of minimally invasive surgery, this operation continues to be performed most commonly in an open fashion. Open PD (OPD) is characterized by high morbidity and mortality rates in published series. Since the early 2000s, use of robotics for PD has slowly evolved. For appropriately selected patients, robotic PD (RPD) has been shown to have less intraoperative blood loss, decreased morbidity and mortality, shorter hospital length of stay, and similar oncological outcomes compared with OPD. At our high-volume center, we have found lower complication rates for RPD along with no difference in total cost when compared with OPD. With demonstrated non-inferior oncologic outcomes for RPD, the potential exists that RPD may be the future standard in surgical management for pancreatic disease. We present a case of a patient with a pancreatic head mass and describe our institution's surgical technique for RPD.
胰十二指肠切除术（PD）被认为是普通外科医生进行的最复杂、技术要求最高的腹部手术之一。随着微创手术的使用增加，该手术仍最常以开放方式进行。在已发表的系列研究中，开放胰十二指肠切除术（OPD）的特点是发病率和死亡率较高。自21世纪初以来，机器人辅助胰十二指肠切除术（RPD）的应用逐渐发展。对于经过适当选择的患者，与OPD相比，RPD已被证明术中失血更少、发病率和死亡率降低、住院时间缩短且肿瘤学结局相似。在我们的高流量中心，我们发现RPD的并发症发生率较低，与OPD相比总成本没有差异。鉴于RPD已证明具有非劣效的肿瘤学结局，RPD有可能成为胰腺疾病外科治疗的未来标准。我们介绍一例胰头肿块患者的病例，并描述我们机构的RPD手术技术。
