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23 September 2015 : Clinical Research  

Robot-Assisted Middle Pancreatectomy for Elderly Patients: Our Initial Experience

Tian ZhangBCE, Xinjing WangBCE, Zhen HuoB, Chenlei WenC, Zhichong WuB, Jiabin JinBC, Dongfeng ChengC, Hao ChenF, Xiaxing DengAD, Baiyong ShenD, Chenghong PengAD

DOI: 10.12659/MSM.895477

Med Sci Monit 2015; 21:2851-2860

Abstract

BACKGROUND: The aim of this study was to evaluate the indications, safety, feasibility, and short- and long-term outcomes for elderly patients who underwent robot-assisted middle pancreatectomies (MPs).

MATERIAL AND METHODS: Ten patients (≥60 years) underwent robot-assisted middle pancreatectomies from 2012 to 2015. The perioperative data, including tumor size, operating time, rate of postoperative pancreatic fistula (POPF), postoperative morbidity, and other parameters, were analyzed. We collected and analyzed the follow-up information.

RESULTS: The mean age of patients was 64.30 years (range, 60–73 years). The average tumor size was 2.61 cm. The 10 cases were all benign or low-grade malignant lesions. The mean operating time was 175.00 min. The mean blood loss was 113.00 ml with no blood transfusion needed. Postoperative fistulas developed in 5 patients; there were 2 Grade A fistulas and 3 grade B fistulas. There were 3 patients who underwent postoperative complications, including 2 Grade 1 or 2 complications and 1 Grade 3 complication. No reoperation and postoperative mortality occurred. The mean hospital stay was 19.91 days. After a median follow-up of 23 months, new onset of diabetes mellitus developed in 1 patient and none suffered from deterioration of previously diagnosed diabetes or exocrine insufficiency, and no tumor recurrence happened.

CONCLUSIONS: Robot-assisted middle pancreatectomy was safe and feasible for elderly people. It had low risk of exocrine or endocrine dysfunction and benefited patients’ long-term outcomes. Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.

Keywords: Follow-Up Studies, operative time, Pancreas - surgery, Pancreatectomy - methods, Pancreatic Neoplasms - surgery, Postoperative Complications, Robotic Surgical Procedures

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Medical Science Monitor eISSN: 1643-3750
Medical Science Monitor eISSN: 1643-3750