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Background: Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a mucin-producing tumor that develops from the epithelial lining of the main pancreatic duct or branch pancreatic ducts. Here, we assessed the feasibility and safety of various robotic pancreatectomy approaches to treating IPMN, and short- and long-term outcomes of robotic IPMN resection.
Methods: Data from patients who underwent robotic pancreatectomy for IPMN between 2012 and 2019 at our hospital were retrospectively analyzed. The survival outcomes for patients were compared using the Kaplan-Meier method and Cox regression analysis.
Results: Of the 174 patients who underwent robotic pancreatectomy, 120 and 54 patients had benign or malignant tumors, respectively. Patients with malignant IPMN had lost more weight in the 6 months prior to surgery (P = .008), and a higher serum level of CA19-9 (P < .001) and CEA (P < .001). Postoperative pancreatic or biliary fistula occurred in 17 or 6 patients overall, respectively. The pathology of the IPMN (P = .030), tumor diameter (P = .016), mural nodule (P = .023), tumor capsule (P = .003) and CA19-9 (P = .024) values were all independent risk factors for survival. The median OS time after surgical resection for the malignant IPMN group was 29.0 months (range, 21.6-36.4). The OS was significantly different in patients with IPMN according to their different pathology, tumor capsule, mural nodule group, CA19-9 level, or tumor diameter.
Conclusions: This large-scale survey of 174 patients indicated that various robotic pancreatectomy approaches were feasible and safe for IPMN. Patients had an acceptable prognosis, indicating that robotic pancreatectomy represents a feasible potential therapeutic strategy for IPMN.
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http://dx.doi.org/10.1002/jhbp.864 | DOI Listing |
Ann Surg Oncol
September 2025
Hepato‑Biliary and Pancreatic Surgery Unit, Department of Surgery, Hospital del Mar, Pompeu Fabra University, Barcelona, Spain.
Background: Spleen-preserving distal pancreatectomy by robotic surgery is a safe and feasible surgical technique. Currently, spleen-preserving distal pancreatectomy represents an alternative to the classical distal pancreatectomy with splenectomy, in the case of benign and low-grade malignant diseases of the body or pancreas tail. The reasons for preserving the spleen are based on the reduction of postoperative complications, such as post-splenectomy infections, subphrenic abscess, portal thrombosis, pulmonary hypertension, thrombocytosis, and thromboembolism.
View Article and Find Full Text PDFBackground: Costs associated with robotic pancreatectomy compared to those of open pancreatectomy are assumed to be high but are not well known, particularly during the initial implementation of the robot.
Study Design: Patients who underwent pancreatectomy for any diagnosis from January 2017 to August 2021 were identified retrospectively. Total hospital cost was calculated using intraoperative, inpatient, and outpatient costs within 30 days of surgery.
Background: This systematic review and meta-analysis compared the intraoperative and postoperative outcomes of minimally invasive versus open distal pancreatectomy (ODP) in patients with pancreatic ductal adenocarcinoma (PDAC), which is a highly aggressive tumor with a high mortality rate. Surgical resection remains the only potentially curative treatment. Minimally invasive distal pancreatectomy (MIDP), including laparoscopic and robotic approaches, has gained popularity, although the evidence of its efficacy is limited.
View Article and Find Full Text PDFUpdates Surg
September 2025
Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University Hospital of Modena "Policlinico", University of Modena and Reggio Emilia, 41124, Modena, Italy.
The robotic approach to liver and pancreatic surgery is expanding worldwide. However, limited data are available on vascular management in these complex procedures. The unique characteristics of the robotic platform may enhance the feasibility of minimally invasive vascular resection and reconstruction.
View Article and Find Full Text PDFAnn Surg Oncol
September 2025
Hepato-Pancreato-Biliary and Liver Transplant Surgery Unit, Department of Surgical, Oncological and Gastroenterological Sciences (DiSCOG), University of Padua, Padua, Italy.
Background: Different techniques for venous resection and reconstruction during pancreatoduodenectomy are available, each with different advantages and drawbacks.
Patients And Methods: In this multimedia article, a detailed description of the surgical technique of venous resection with peritoneal (falciform) patch reconstruction is provided, including examples of extended (> 5 cm) or low (jejunal veins confluence) venous infiltrations, during both open and robotic pancreatoduodenectomy.
Results: Reconstruction with patch is a versatile technique, typically fit for lateral but cranio-caudally prolonged tumor involvements, which unlike segmental resection allows preservation of venous collaterals, where a simple tangential resection would jeopardize oncologic radicality or increase the risk of stenosis.