Wei Zhi-Gang, Liang Chao-Jie, Du Yang, Zhang Yong-Ping, Liu Yu
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
World J Clin Cases. 2022 May 16;10(14):4357-4367. doi: 10.12998/wjcc.v10.i14.4357.
Robotic pancreaticoduodenectomy (RPD) can achieve similar surgical results to open and PD; however, RPD has a long learning curve and operation time (OT). To address this issue, we have summarized a surgical path to shorten the surgical learning curve and OT.
To investigate the effective learning curve of a "G"-shaped surgical approach in RPD for patients.
A total of 60 patients, who received "G"-shaped RPD (GRPD) by a single surgeon in the First Hospital of Shanxi Medical University from May 2017 to April 2020, were included in this study. The OT, demographic data, intraoperative blood loss, complications, hospitalization time, and pathological results were recorded, and the cumulative sum (CUSUM) analysis was performed to evaluate the learning curve for GRPD.
According to the CUSUM analysis, the learning curve for GRPD was grouped into two phases: The early and late phases. The OT was 480 ± 81.65 min 331 ± 76.54 min, hospitalization time was 22 ± 4.53 d 17 ± 6.08 d, and blood loss was 308 ± 54.78 mL 169.2 ± 35.33 mL in the respective groups. Complications, including pancreatic fistula, bile leakage, reoperation rate, postoperative death, and delayed gastric emptying, were significantly decreased after this surgical technique.
GRPD can improve the learning curve and operative time, providing a new method for shortening the RPD learning curve.
机器人胰十二指肠切除术（RPD）可取得与开放手术和传统胰十二指肠切除术（PD）相似的手术效果；然而，RPD存在较长的学习曲线和手术时间（OT）。为解决这一问题，我们总结了一条缩短手术学习曲线和手术时间的手术路径。
探讨“G”形手术入路在RPD患者中的有效学习曲线。
本研究纳入了2017年5月至2020年4月在山西医科大学第一医院由同一外科医生实施“G”形RPD（GRPD）的60例患者。记录手术时间、人口统计学数据、术中出血量、并发症、住院时间和病理结果，并进行累积和（CUSUM）分析以评估GRPD的学习曲线。
根据CUSUM分析，GRPD的学习曲线分为两个阶段：早期和晚期。各阶段的手术时间分别为480±81.65分钟和331±76.54分钟，住院时间分别为22±4.53天和17±6.08天，出血量分别为308±54.78毫升和169.2±35.33毫升。采用该手术技术后，包括胰瘘、胆漏、再次手术率、术后死亡和胃排空延迟在内的并发症显著减少。
GRPD可改善学习曲线和手术时间，为缩短RPD学习曲线提供了一种新方法。
