Robot‐assisted duodenum‐preserving pancreatic head resection with pancreaticogastrostomy for benign or premalignant pancreatic head lesions: a single‐centre experience

Abstract

Modified RA-DPPHR benefits in terms of better conservation of exocrine and endocrine pancreatic functions at the expense of a significant morbidity and non-zero mortality.

Resection of the duodenum causes long-term endocrine and exocrine dysfunction after Whipple procedure for benign tumors - Results of a systematic review and meta-analysis

“…In six of the hormone studies, data of pNODM and PEI of the same cohort of patients were additionally reported; the results were included in both, review and metaanalysis. 9,10,15,18,20,29 One study presented multiple determinations of micronutrients after sPD. 19…”

Short-term and long term morbidity in robotic pancreatic surgery: a systematic review

“…In line with literature values, POPF rates were higher in patients treated with RPD than those who underwent RDP. Although the high value of POPF showed by Jiang et al (20), in their review, there were no significant differences between RA-DPPHR and RA-PD groups in terms of frequencies of POPFs and biliary fistula (11.8% vs. 8.8%) (20). Postoperative complications were analyzed almost in all the reports through the Clavien-Dindo scoring system (CDC).…”

“…The remaining items included surgical approaches such as robotic middle pancreatectomy (RMP) (15,16), robotic distal pancreatectomy and splenectomy (17), robotic-assisted laparoscopic pancreatic dissection (RALPD) (18), robotic enucleation of pancreatic neuroendocrine tumors (19). At last, one study (20) evaluated outcomes of patients treated with modified roboticassisted duodenum preserving pancreatic head resection (RA-DPPHR) and those treated with robotic-assisted pancreatoduodenectomy (RA-PD). All studies reported the median operative time (O.T.…”

“…In a study (18) analyzing the learning curve of RLPD was reported a decreasing operative time from 2010 to 2013 (445 vs. 340 min). Blood loss was reported in 15 studies (3,(6)(7)(8)(10)(11)(12)(13)(15)(16)(17)(18)(19)(20)(21), with a range of 30-4,500 mL, more elevated for P.D. than for D.P.…”

Robotics in Pancreatic Surgery

“…Few case reports or case series have been published [i.e. for duodenum-preserving pancreatic head resection (46,47)] and underline the feasibility of these operations in experienced centers. Despite this, these indications and procedures remain rare and high-level evidence studies are unlikely to be expected due to the low frequency of performance.…”