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1000 Titel
  • Challenges of single-stage pancreatoduodenectomy: how to address pancreatogastrostomies with robotic-assisted surgery
1000 Autor/in
  1. Timmermann, Lea |
  2. Hillebrandt, Karl Herbert |
  3. Felsenstein, Matthäus |
  4. Schmelzle, Moritz |
  5. Pratschke, Johann |
  6. Malinka, Thomas |
1000 Erscheinungsjahr 2021
1000 Publikationstyp
  1. Artikel |
1000 Online veröffentlicht
  • 2021-12-09
1000 Erschienen in
1000 Quellenangabe
  • 36(9):6361-6367
1000 Copyrightjahr
  • 2021
1000 Lizenz
1000 Verlagsversion
  • https://doi.org/10.1007/s00464-021-08925-w |
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9402518/ |
1000 Publikationsstatus
1000 Sprache der Publikation
1000 Abstract/Summary
  • Introduction!#!Establishing a sufficient pancreatico-enteric anastomosis remains one of the most important challenges in open single stage pancreatoduodenectomy as they are associated with persisting morbidity and mortality. Applicability on a robotic-assisted approach, however, even increases the requirements. With this analysis we introduce a dorsal-incision-only invagination type pancreatogastrostomy (dioPG) to the field of robotic assistance having been previously proven feasible in the field of open pancreatoduodenectomy and compare initial results to the open approach by means of morbidity and mortality.!##!Methods!#!An overall of 142 consecutive patients undergoing reconstruction via the novel dioPG, 38 of them in a robotic-assisted and 104 in an open approach, was identified and further reviewed for perioperative parameters, complications and mortality.!##!Results!#!We observed a comparable R0-resection rate (p = 0.448), overall complication rate (p = 0.52) and 30-day mortality (p = 0.71) in both groups. Rates of common complications, such as postoperative pancreatic fistula (p = 0.332), postoperative pancreatic hemorrhage (p = 0.242), insufficiency of pancreatogastrostomy (p = 0.103), insufficiency of hepaticojejunostomy (p = 0.445) and the re-operation rate (p = 0.103) were comparable. The procedure time for the open approach was significantly shorter compared to the robotic-assisted approach (p = 0.024).!##!Discussion!#!The provided anastomosis appeared applicable to a robotic-assisted setting resulting in comparable complication and mortality rates when compared to an open approach. Nevertheless, also in the field of robotic assistance establishing a predictable pancreatico-enteric anastomosis remains the most challenging aspect of modern single-stage pancreatoduodenectomy and requires expertise and experience.
1000 Sacherschließung
lokal Pancreaticoduodenectomy/adverse effects [MeSH]
lokal Pancreatic Fistula/complications [MeSH]
lokal Robotic-assisted
lokal Humans [MeSH]
lokal Pancreatoduodenectomy
lokal Pancreatic Fistula/etiology [MeSH]
lokal Postoperative Complications/epidemiology [MeSH]
lokal Postoperative Complications/surgery [MeSH]
lokal Postoperative Hemorrhage/surgery [MeSH]
lokal Pancreatogastrostomy
lokal Anastomosis, Surgical/adverse effects [MeSH]
lokal Article
lokal Robotic Surgical Procedures/adverse effects [MeSH]
lokal Pancreaticoduodenectomy/methods [MeSH]
lokal Pancreato-enteric anastomosis
lokal Postoperative Complications/etiology [MeSH]
lokal Pancreas/surgery [MeSH]
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1000 Erstellt am 2023-05-09T10:02:55.188+0200
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1000 Zuletzt bearbeitet Sat Oct 21 01:30:26 CEST 2023
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