Minimally Invasive Pancreatic Enucleation: comparing laparoscopic and robot-assisted surgery.
EAES Academy. Andreotti E. 07/05/22; 363138; P183
Elena Andreotti
Contributions
Contributions
Abstract
Aims:
The role and the indications for minimally invasive approaches in pancreatic enucleation (PE) have been poorly investigated. This study aims to compare laparoscopic (LPE) and robot-assisted (RPE) approaches for pancreatic enucleations.
Methods:
Data from all consecutive patients undergoing minimally invasive PE from January 2008 to December 2020 were retrospectively analyzed. The patients were divided into two groups based on the surgical approach (LPE or RPE) and then compared. Preoperative characteristics, intraoperative findings, postoperative outcomes were prospectively collected and retrospectively analyzed.
Results:
In the study period, 33 patients underwent minimally invasive PE, of which 22 (67%) LPE and 11 (33%) RPE. There was no difference in sex (p= 0.26), BMI (p= 0.19) and tumor size (p= 0.89) between the two groups. Compared to LRE, RPEs have been progressively adopted for pancreatic head lesions closer to the main pancreatic duct requiring the placement of Wirsung stents (0% vs. 27.3%; p=0.03). This translates into a longer operative time in the RPE than the LPE group (130 min [IQR 95-160 min] vs. 200 min [IQR 175-316 min], p<0.001). Despite no statistical differences in overall morbidity (27.3% in LPE vs. 54.5% in RPE, p=0.14), RPE was associated with a longer length of hospital stay than LPE (9 days [6-19 days] vs. 6 days [5.7-7 days], p=0.02).
Conclusions:
Minimally invasive PE is a valid option for treating benign or pre-malignant pancreatic diseases. LPE is feasible and safe for more exophytic pancreatic lesions and is associated with short hospital stays. The RPE is a viable alternative for demanding procedures previously carried out by open surgery only.
The role and the indications for minimally invasive approaches in pancreatic enucleation (PE) have been poorly investigated. This study aims to compare laparoscopic (LPE) and robot-assisted (RPE) approaches for pancreatic enucleations.
Methods:
Data from all consecutive patients undergoing minimally invasive PE from January 2008 to December 2020 were retrospectively analyzed. The patients were divided into two groups based on the surgical approach (LPE or RPE) and then compared. Preoperative characteristics, intraoperative findings, postoperative outcomes were prospectively collected and retrospectively analyzed.
Results:
In the study period, 33 patients underwent minimally invasive PE, of which 22 (67%) LPE and 11 (33%) RPE. There was no difference in sex (p= 0.26), BMI (p= 0.19) and tumor size (p= 0.89) between the two groups. Compared to LRE, RPEs have been progressively adopted for pancreatic head lesions closer to the main pancreatic duct requiring the placement of Wirsung stents (0% vs. 27.3%; p=0.03). This translates into a longer operative time in the RPE than the LPE group (130 min [IQR 95-160 min] vs. 200 min [IQR 175-316 min], p<0.001). Despite no statistical differences in overall morbidity (27.3% in LPE vs. 54.5% in RPE, p=0.14), RPE was associated with a longer length of hospital stay than LPE (9 days [6-19 days] vs. 6 days [5.7-7 days], p=0.02).
Conclusions:
Minimally invasive PE is a valid option for treating benign or pre-malignant pancreatic diseases. LPE is feasible and safe for more exophytic pancreatic lesions and is associated with short hospital stays. The RPE is a viable alternative for demanding procedures previously carried out by open surgery only.
Aims:
The role and the indications for minimally invasive approaches in pancreatic enucleation (PE) have been poorly investigated. This study aims to compare laparoscopic (LPE) and robot-assisted (RPE) approaches for pancreatic enucleations.
Methods:
Data from all consecutive patients undergoing minimally invasive PE from January 2008 to December 2020 were retrospectively analyzed. The patients were divided into two groups based on the surgical approach (LPE or RPE) and then compared. Preoperative characteristics, intraoperative findings, postoperative outcomes were prospectively collected and retrospectively analyzed.
Results:
In the study period, 33 patients underwent minimally invasive PE, of which 22 (67%) LPE and 11 (33%) RPE. There was no difference in sex (p= 0.26), BMI (p= 0.19) and tumor size (p= 0.89) between the two groups. Compared to LRE, RPEs have been progressively adopted for pancreatic head lesions closer to the main pancreatic duct requiring the placement of Wirsung stents (0% vs. 27.3%; p=0.03). This translates into a longer operative time in the RPE than the LPE group (130 min [IQR 95-160 min] vs. 200 min [IQR 175-316 min], p<0.001). Despite no statistical differences in overall morbidity (27.3% in LPE vs. 54.5% in RPE, p=0.14), RPE was associated with a longer length of hospital stay than LPE (9 days [6-19 days] vs. 6 days [5.7-7 days], p=0.02).
Conclusions:
Minimally invasive PE is a valid option for treating benign or pre-malignant pancreatic diseases. LPE is feasible and safe for more exophytic pancreatic lesions and is associated with short hospital stays. The RPE is a viable alternative for demanding procedures previously carried out by open surgery only.
The role and the indications for minimally invasive approaches in pancreatic enucleation (PE) have been poorly investigated. This study aims to compare laparoscopic (LPE) and robot-assisted (RPE) approaches for pancreatic enucleations.
Methods:
Data from all consecutive patients undergoing minimally invasive PE from January 2008 to December 2020 were retrospectively analyzed. The patients were divided into two groups based on the surgical approach (LPE or RPE) and then compared. Preoperative characteristics, intraoperative findings, postoperative outcomes were prospectively collected and retrospectively analyzed.
Results:
In the study period, 33 patients underwent minimally invasive PE, of which 22 (67%) LPE and 11 (33%) RPE. There was no difference in sex (p= 0.26), BMI (p= 0.19) and tumor size (p= 0.89) between the two groups. Compared to LRE, RPEs have been progressively adopted for pancreatic head lesions closer to the main pancreatic duct requiring the placement of Wirsung stents (0% vs. 27.3%; p=0.03). This translates into a longer operative time in the RPE than the LPE group (130 min [IQR 95-160 min] vs. 200 min [IQR 175-316 min], p<0.001). Despite no statistical differences in overall morbidity (27.3% in LPE vs. 54.5% in RPE, p=0.14), RPE was associated with a longer length of hospital stay than LPE (9 days [6-19 days] vs. 6 days [5.7-7 days], p=0.02).
Conclusions:
Minimally invasive PE is a valid option for treating benign or pre-malignant pancreatic diseases. LPE is feasible and safe for more exophytic pancreatic lesions and is associated with short hospital stays. The RPE is a viable alternative for demanding procedures previously carried out by open surgery only.
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