Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital and School of Medicine, National Yang-Ming University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2020 Jul;83(7):639-643. doi: 10.1097/JCMA.0000000000000333.
Minimally invasive surgery has become a worldwide trend to reduce the wound and mitigate pain. However, the role of robotic pancreaticoduodenectomy (RPD) has not been well established in the era of minimally invasive surgery. It would be nearly impossible to apply minimally invasive surgery in the tedious and complicated Whipple operation without an experienced and dedicated pancreas team. The pancreatic team led by Shyr YM and Wang SE at Taipei Veterans General Hospital have already been highly accredited with a Copper Award of Symbol of National Quality (SNQ award), entitled with "Minimally Invasive Robotic Pancreatic Surgery-Small Wound for Major Pancreatic Surgery" in Taiwan in 2019. RPD was claimed to be associated with less blood loss, less delayed gastric emptying, shorter length of postoperative stay, and lower wound infection rate, but longer operative time, as compared with the traditional open pancreaticoduodenectomy (OPD). More than 99% of the patients undergoing minimally invasive RPD are satisfied with the surgical outcomes and would like to recommend RPD to those with periampullary lesions. RPD could be recommended not only to surgeons but also to patients in terms of surgical outcomes and patient satisfaction. Moreover, our study showed a survival benefit for pancreatic head adenocarcinoma in RPD group, with 1-year, 3-year, and 5-year survival of 82.9%, 45.3%, and 26.8%, respectively, as compared with 63.8%, 26.2%, and 17.4% in OPD.
微创手术已成为减少创伤和减轻疼痛的全球趋势。然而，在微创手术时代，机器人胰十二指肠切除术（RPD）的作用尚未得到充分确立。如果没有经验丰富且专注的胰腺团队，繁琐复杂的胰头十二指肠切除术几乎不可能采用微创手术。在台湾，台北荣民总医院的 Shyr YM 和 Wang SE 领导的胰腺团队已经获得了铜奖（SNQ 奖）的高度认可，其主题为“微创机器人胰腺手术——大胰腺手术的小创伤”。与传统的开腹胰十二指肠切除术（OPD）相比，RPD 据称具有出血量减少、胃排空延迟减少、术后住院时间缩短和伤口感染率降低的优点，但手术时间更长。超过 99%接受微创 RPD 的患者对手术结果满意，并愿意向壶腹周围病变患者推荐 RPD。无论从手术结果还是患者满意度来看，RPD 不仅可以推荐给外科医生，也可以推荐给患者。此外，我们的研究显示，RPD 组胰头腺癌患者的生存获益，1 年、3 年和 5 年的生存率分别为 82.9%、45.3%和 26.8%，而 OPD 组分别为 63.8%、26.2%和 17.4%。
