dc.contributor.author
Timmermann, Lea
dc.contributor.author
Hillebrandt, Karl Herbert
dc.contributor.author
Felsenstein, Matthäus
dc.contributor.author
Schmelzle, Moritz
dc.contributor.author
Pratschke, Johann
dc.contributor.author
Malinka, Thomas
dc.date.accessioned
2023-07-19T13:14:09Z
dc.date.available
2023-07-19T13:14:09Z
dc.identifier.uri
https://refubium.fu-berlin.de/handle/fub188/40178
dc.identifier.uri
http://dx.doi.org/10.17169/refubium-39899
dc.description.abstract
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.
en
dc.rights.uri
https://creativecommons.org/licenses/by/4.0/
dc.subject
Pancreatogastrostomy
en
dc.subject
Pancreato-enteric anastomosis
en
dc.subject
Pancreatoduodenectomy
en
dc.subject
Robotic-assisted
en
dc.subject.ddc
600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit
dc.title
Challenges of single-stage pancreatoduodenectomy: how to address pancreatogastrostomies with robotic-assisted surgery
dc.type
Wissenschaftlicher Artikel
dcterms.bibliographicCitation.doi
10.1007/s00464-021-08925-w
dcterms.bibliographicCitation.journaltitle
Surgical Endoscopy
dcterms.bibliographicCitation.number
9
dcterms.bibliographicCitation.originalpublishername
Springer Nature
dcterms.bibliographicCitation.pagestart
6361
dcterms.bibliographicCitation.pageend
6367
dcterms.bibliographicCitation.volume
36
refubium.affiliation
Charité - Universitätsmedizin Berlin
refubium.resourceType.isindependentpub
no
dcterms.accessRights.openaire
open access
dcterms.bibliographicCitation.pmid
34888711
dcterms.isPartOf.issn
0930-2794
dcterms.isPartOf.eissn
1432-2218