Qu Liu1, Zhiming Zhao1, Yuanxing Gao1, Guodong Zhao1, Xianglong Tan1, Chihyuan Wang2, Rong Liu1. 1. Second Department of Hepatopancreatobiliary Surgery, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Beijing, 100853, China. 2. Department of General Surgery, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan, China.
Abstract
BACKGROUND: The best technique for pancreatic anastomosis after pancreaticoduodenectomy (PD) remains controversial, and the procedure for robotic PD (RPD) has not been previously reported. This study aimed to evaluate the safety and feasibility of a novel technique of pancreaticojejunostomy (PJ) for RPD. METHODS: The demographics and perioperative outcomes of a consecutive series of RPD patients who underwent single-layer continuous suture (SCS) for PJ between September 2018 and November 2018 were analyzed. RESULTS: Thirty patients were included in the study. Twenty patients had a soft pancreas, and 15 patients had a small main pancreatic duct (MPD) (<3 mm). The mean operative time was 234.1 min, the mean duration of PJ was 14.9 min, and the median estimated blood loss was 100.0 ml. No patients required conversion to laparotomy. Postoperative pancreatic fistula (POPF) included seven cases of Grade A and two cases of Grade B. No case of Grade C POPF occurred. The mean postoperative hospital stay was 12.3 days. No 90-day readmission or mortality was observed. Neither pancreatic texture nor MPD size affected the perioperative outcomes. CONCLUSIONS: Single-layer continuous suture is easy to perform and is associated with favorable clinical outcomes, regardless of the pancreatic duct size and texture.
BACKGROUND: The best technique for pancreatic anastomosis after pancreaticoduodenectomy (PD) remains controversial, and the procedure for robotic PD (RPD) has not been previously reported. This study aimed to evaluate the safety and feasibility of a novel technique of pancreaticojejunostomy (PJ) for RPD. METHODS: The demographics and perioperative outcomes of a consecutive series of RPD patients who underwent single-layer continuous suture (SCS) for PJ between September 2018 and November 2018 were analyzed. RESULTS: Thirty patients were included in the study. Twenty patients had a soft pancreas, and 15 patients had a small main pancreatic duct (MPD) (<3 mm). The mean operative time was 234.1 min, the mean duration of PJ was 14.9 min, and the median estimated blood loss was 100.0 ml. No patients required conversion to laparotomy. Postoperative pancreatic fistula (POPF) included seven cases of Grade A and two cases of Grade B. No case of Grade C POPF occurred. The mean postoperative hospital stay was 12.3 days. No 90-day readmission or mortality was observed. Neither pancreatic texture nor MPD size affected the perioperative outcomes. CONCLUSIONS: Single-layer continuous suture is easy to perform and is associated with favorable clinical outcomes, regardless of the pancreatic duct size and texture.
Authors: Qu Liu; Zhiming Zhao; Guodong Zhao; Yuanxing Gao; Nan Jiang; Wan Yee Lau; Rong Liu Journal: Ann Surg Oncol Date: 2020-10-20 Impact factor: 5.344
Authors: Delin Ma; Gang Du; Jinhuan Yang; Jianping Song; Huan Ma; Jianlei Wang; Tingxiao Zhang; Bin Jin Journal: Biomed Res Int Date: 2021-03-13 Impact factor: 3.411