Laparoscopic Pancreaticoduodenectomy: A Single Team Preliminary Experience

Duan, Xiaohui; Jiang, Bo; Zhou, Lixue; Yang, Jianhui; Tian, Bin; Wen, Huiming; Mao, Xianhai

doi:10.1097/sle.0000000000000442

Cited by 10 publications

(6 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…LPD was first described by Gagner and Pomp in 1994 2 , while RAPD was first performed by Giulianotti et al in 2001 5 . LPD is a safe and effective procedure in specialized high-volume medical centers 4,9,10 . However, traditional laparoscopy systems are associated with intrinsic disadvantages, including two-dimensional visualization, poor surgeon ergonomics, and a restricted range of movement (up to only four degrees of freedom) inside the abdominal cavity due to the straight bodies of laparoscopic instruments.…”

Section: Discussionmentioning

confidence: 99%

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Zhou

Miao

et al. 2020

Sci Rep

View full text Add to dashboard Cite

to analyze the initial learning curve (Lc) for robot-assisted pancreaticoduodenectomy (RApD) and compare RApD during the initial Lc with open pancreaticoduodenectomy (opD) in terms of outcome. this study is a retrospective review of patients who consecutively underwent RApD and opD between October 2015 and January 2020 in our hospital. 41 consecutive RAPD cases and 53 consecutive open cases were enrolled for review. Compared with OPD, RAPD required a significantly longer operative time (401.1 ± 127.5 vs. 230.8 ± 44.5 min, P < 0.001) and higher cost (194621 ± 78342 vs. 121874 ± 39973 CNY, P < 0.001). Moreover, compared with the OPD group, the RAPD group revealed a significantly smaller mean number of lymph nodes harvested in malignant cases (15.6 ± 5.9 vs 18.9 ± 7.3, P = 0.025). No statistically significant differences were observed between the two groups in terms of incidence of Clavien-Dindo grade III-V morbidities and 90-day mortality and readmission (p>0.05). In the CUSUM graph, one peak point was observed at the 8th case, after which the operation time began to decrease. LC for RAPD may be less than 30 cases, and RAPD is safe and feasible during the initial Lc. Although pancreatectomy was first performed 80 years ago, it remains a challenging abdominal surgery with relatively high morbidity and mortality 1. Laparoscopic pancreaticoduodenectomy (LPD) was first reported in 1994 by Gagner 2 ; today, this procedure could be performed as safely as open pancreaticoduodenectomy (OPD) by skilled surgeons 3,4. However, the long learning curve (LC) for LPD continues to challenge many surgeons. In general, LPD presents intrinsic disadvantages compared with conventional laparotomy, including instrument motion, two-dimensional imaging, poor surgeon ergonomics, and a long LC. In 2000, the Da Vinci system was approved by the Food and Drug Administration. In 2003, Giulianotti et al. published a case series verifying the feasibility of robotic pancreatectomy; the series included eight robot-assisted pancreaticoduodenectomy (RAPD) and five robot-assisted distal pancreatectomy (RADP) cases 5. Robotic surgery is an advanced minimally invasive surgical technique that has several benefits in pancreaticoduodenectomy, such as enhanced three-dimensional vision, application of EndoWrist instruments (which have a great range of motion), and a short LC. However, the safety of RAPD during the initial LC and the possible shortening of the LC remain unclear. Therefore, this article addresses the LC of a single surgical team in our hospital. Methods patient Selection. This study is a retrospective research on pancreaticoduodenectomy conducted by a single surgical team. Our team had performed over 200 OPD before

show abstract

Section: Discussionmentioning

confidence: 99%

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Zhou

Miao

et al. 2020

Sci Rep

View full text Add to dashboard Cite

show abstract

“…Pancreaticoduodenectomy (PD) is curative treatment for periampullary and pancreatic disease (1). Obstructive jaundice is the most common symptom in patients with periampullary cancer.…”

Section: Introductionmentioning

confidence: 99%

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

et al. 2021

View full text Add to dashboard Cite

Background: Preoperative biliary drainage prior to pancreaticoduodenectomy (PD) by percutaneous transhepatic biliary drainage (PTBD) or endoscopic biliary drainage (EBD) is performed to improve liver functions, including immunity and coagulation that affect postoperative recovery in patients with jaundice.EBD can be performed through endoscopic retrograde biliary drainage (ERBD) or endoscopic nasobiliary drainage (ENBD). There is no clear consensus about which drainage is more suitable for preoperative EBD.

show abstract

“…It has been confirmed that the degree of surgical trauma and stress is obvious in patients who receive blood transfusion because of acute blood loss during operation, which will inhibit their immune system, and the blood transfusion operation will aggravate the inhibition [ 16 , 17 ]. Therefore, it is possible to reduce the risk of pulmonary infection by formulating relevant measures in clinical works, according to the above risk factors [ 18 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Study on the Risk Factors of Pulmonary Infection after Laparoscopic Surgery and Analysis of the Detection Results of Drug-Resistant Bacteria

Zhai

Zhang

Sun

et al. 2022

Journal of Healthcare Engineering

View full text Add to dashboard Cite

This study aimed to investigate and analyze the risk of pulmonary infection after laparoscopic surgery and the detection results of drug-resistant bacteria. With the laparoscopic technology developing rapidly in recent years and people’s minimally invasive concept improving continuously, laparoscopic radical surgery has been widely used in the treatment of a variety of diseases. Laparoscopic surgery has the probability of causing complications. In order to avoid this, the risk factors after surgery were analyzed, and the drug-resistant bacteria were analyzed for accurate prevention and treatment. A total of 600 patients who underwent elective laparoscopic surgery in our hospital from January 2017 to September 2021 were included in the study. The risk factors and pathogen distribution of pulmonary infection were analyzed. The risk factors of pulmonary infection after laparoscopic surgery were hypoproteinemia, diabetes mellitus, pulmonary disease history, and perioperative blood transfusion. The main pathogens were Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Streptococcus pneumoniae. In clinical work, relevant nursing intervention measures can be developed for the above factors, so as to reduce the incidence of pulmonary infection. This study finds the risk factors for pulmonary infection after surgery, and the common drug-resistant bacteria has an indicative and guiding effect on the formulation of nursing management measures.

show abstract

Laparoscopic Pancreaticoduodenectomy: A Single Team Preliminary Experience

Abstract: LPD, although complicated and difficult, serve as a safe and effective method for experienced surgeons.

Cited by 10 publications

References 15 publications

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Outcome of robot-assisted pancreaticoduodenectomy during initial learning curve versus laparotomy

Preoperative endoscopic retrograde biliary drainage increases postoperative complications after pancreaticoduodenectomy compared to endoscopic nasobiliary drainage

Study on the Risk Factors of Pulmonary Infection after Laparoscopic Surgery and Analysis of the Detection Results of Drug-Resistant Bacteria

Contact Info

Product

Resources

About