Lee Shi Qing, Kabir Tousif, Koh Ye-Xin, Teo Jin-Yao, Lee Ser-Yee, Kam Juinn-Huar, Cheow Peng-Chung, Jeyaraj Prema Raj, Chow Pierce K H, Ooi London L, Chung Alexander Y F, Chan Chung-Yip, Goh Brian K P
Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Ann Hepatobiliary Pancreat Surg. 2020 Aug 31;24(3):283-291. doi: 10.14701/ahbps.2020.24.3.283.
BACKGROUNDS/AIMS: This study aims to describe our experience with minimally-invasive distal pancreatectomies, with emphasis on the comparison between robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP).
Retrospective review of 102 consecutive RDP and LDP from 2006 to 2019 was performed.
There were 27 and 75 patients who underwent RDP and LDP, respectively. There were 12 (11.8%) open conversions and 16 (15.7%) patients had major (＞grade 2) morbidities. Patients who underwent RDP had significantly higher rates of splenic preservation (44.4% vs. 13.3%, p=0.002), higher rates of splenic-vessel preservation (40.7% vs. 9.3%, p=0.001), higher median difficulty score (5 vs. 3, p=0.002) but longer operation time (385 vs. 245 minutes, p＜0.001). The rate of open conversion tended to be lower with RDP (3.7% vs. 14.7%, p=0.175).
In our institution practice, both RDP and LDP were safe and effective. The use of RDP appeared to be complementary to LDP, allowing us to perform more difficult procedures with comparable postoperative outcomes.
背景/目的：本研究旨在描述我们在微创胰体尾切除术方面的经验，重点是比较机器人胰体尾切除术（RDP）和腹腔镜胰体尾切除术（LDP）。
对2006年至2019年连续进行的102例RDP和LDP进行回顾性分析。
分别有27例和75例患者接受了RDP和LDP。有12例（11.8%）转为开放手术，16例（15.7%）患者发生严重（＞2级）并发症。接受RDP的患者脾保留率显著更高（44.4%对13.3%，p = 0.002），脾血管保留率更高（40.7%对9.3%，p = 0.001），中位难度评分更高（5对3，p = 0.002），但手术时间更长（385对245分钟，p＜0.001）。RDP的开放手术转换率有降低趋势（3.7%对14.7%，p = 0.175）。
在我们机构的实践中，RDP和LDP都是安全有效的。RDP的应用似乎是LDP的补充，使我们能够进行更复杂的手术，且术后结果相当。
