Department of Hepatopancreaticobiliary Surgery, Royal Brisbane Hospital, Brisbane, Queensland, Australia.
School of Medicine, Royal Brisbane Clinical Unit, University of Queensland, Brisbane, Queensland, Australia.
ANZ J Surg. 2024 Jul-Aug;94(7-8):1247-1253. doi: 10.1111/ans.18998. Epub 2024 Mar 26.
Minimally invasive pancreatic resection has been gathering interest over the last decade due to the technical demands and high morbidity associated with these typically open procedures. We report our experience with robotic pancreatectomy within an Australian context.
All patients undergoing robotic distal pancreatectomy (DP) and pancreaticoduodenectomy (PD) at two Australian tertiary academic hospitals between May 2014 and December 2020 were included.
Sixty-two patients underwent robotic pancreatectomy during the study period. Thirty-four patients with a median age of 68 years (range 42-84) were in the PD group whilst the DP group included 28 patients with a median age of 60 years (range 18-78). Thirteen patients (46.4%) in the DP group had spleen-preserving procedures. There were 13 conversions (38.2%) in the PD group whilst 0 conversions occurred in the DP group. The Clavien-Dindo grade ≥III complication rate was 26.4% and 17.9% in the PD and DP groups, respectively. Two deaths (5.9%) occurred within 90-days in the PD group whilst none were observed in the DP group. The median length of hospital stay was 11.5 days (range 4-56) in the PD group and 6 days (range 2-22) in the DP group.
Robotic pancreatectomy outcomes at our institution are comparable with international literature demonstrating it is both safe and feasible to perform. With improved access to this platform, robotic pancreas surgery may prove to be the turning point for patients with regards to post-operative complications as more experience is obtained.
由于这些典型的开放性手术的技术要求高和高发病率，微创胰腺切除术在过去十年中引起了关注。我们报告了在澳大利亚背景下进行机器人胰腺切除术的经验。
在 2014 年 5 月至 2020 年 12 月期间，在澳大利亚的两家三级学术医院，所有接受机器人胰远端胰腺切除术（DP）和胰十二指肠切除术（PD）的患者都被纳入本研究。
在研究期间，有 62 名患者接受了机器人胰腺切除术。34 名中位年龄为 68 岁（范围为 42-84 岁）的患者行 PD 术，而 DP 组包括 28 名中位年龄为 60 岁（范围为 18-78 岁）的患者。DP 组中有 13 例（46.4%）患者行保脾手术。PD 组中有 13 例（38.2%）中转开腹，而 DP 组中无中转开腹。PD 组和 DP 组的 Clavien-Dindo 分级≥III 级并发症发生率分别为 26.4%和 17.9%。PD 组中有 2 例（5.9%）患者在 90 天内死亡，而 DP 组中无死亡病例。PD 组的中位住院时间为 11.5 天（范围为 4-56），DP 组为 6 天（范围为 2-22）。
我们机构的机器人胰腺切除术结果与国际文献相当，证明其安全可行。随着对该平台的更好的了解，机器人胰腺手术可能会成为患者术后并发症的转折点，因为随着经验的增加，它可能会更具优势。
