Division of Hepato-Bilio-Pancreatic, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
Division of Hepato-Bilio-Pancreatic, Minimally Invasive and Robotic Surgery, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
HPB (Oxford). 2022 Feb;24(2):143-151. doi: 10.1016/j.hpb.2021.09.014. Epub 2021 Sep 24.
Central pancreatectomy is usually performed to excise lesions of the neck or proximal body of the pancreas. In the last decade, thanks to the advent of novel technologies, surgeons have started to perform this procedure robotically. This review aims to appraise the results and outcomes of robotic central pancreatectomies (RCP) through a systematic review and meta-analysis.
A systematic search of MEDLINE, Embase, and Web Of Science identified studies reporting outcomes of RCP. Pooled prevalence rates of postoperative complications and mortality were computed using random-effect modelling.
Thirteen series involving 265 patients were included. In all cases but one, RCP was performed to excise benign or low-grade tumours. Clinically relevant post-operative pancreatic fistula (POPF) occurred in 42.3% of patients. While overall complications were reported in 57.5% of patients, only 9.4% had a Clavien-Dindo score ≥ III. Re-operation was necessary in 0.7% of the patients. New-onset diabetes occurred postoperatively in 0.3% of patients and negligible mortality and open conversion rates were observed.
RCP is safe and associated with low perioperative mortality and well preserved postoperative pancreatic function, although burdened by high overall morbidity and POPF rates.
胰中部切除术通常用于切除胰腺颈部或近段体部的病变。在过去的十年中，由于新技术的出现，外科医生已经开始使用机器人进行这项手术。本综述旨在通过系统评价和荟萃分析评估机器人胰中部切除术（RCP）的结果和结局。
系统检索 MEDLINE、Embase 和 Web Of Science 以确定报告 RCP 结果的研究。使用随机效应模型计算术后并发症和死亡率的汇总患病率。
共纳入 13 项系列研究，涉及 265 例患者。除 1 例外，所有 RCP 均用于切除良性或低级别肿瘤。临床相关的术后胰瘘（POPF）发生率为 42.3%。虽然报告了 57.5%的患者发生了总体并发症，但只有 9.4%的患者出现了 Clavien-Dindo 评分≥3 级。0.7%的患者需要再次手术。0.3%的患者术后新发糖尿病，死亡率和中转开放率可忽略不计。
RCP 是安全的，围手术期死亡率低，术后胰腺功能保存良好，但总体发病率和 POPF 发生率较高。
