PDF(Pubmed)
Abstract：
BACKGROUND: Parenchymal-sparing approaches to pancreatectomy are technically challenging procedures but allow for preserving a normal pancreas and decreasing the rate of postoperative pancreatic insufficiency. The robotic platform is increasingly being used for these procedures. We sought to evaluate robotic parenchymal-sparing pancreatectomy and assess its complication profile and efficacy.
METHODS: This systematic review consisted of all studies on robotic parenchymal-sparing pancreatectomy (central pancreatectomy, duodenum-preserving partial pancreatic head resection, enucleation, and uncinate resection) published between January 2001 and December 2022 in PubMed and Embase.
RESULTS: A total of 23 studies were included in this review (n = 788). Robotic parenchymal-sparing pancreatectomy is being performed worldwide for benign or indolent pancreatic lesions. When compared to the open approach, robotic parenchymal-sparing pancreatectomies led to a longer average operative time, shorter length of stay, and higher estimated intraoperative blood loss. Postoperative pancreatic fistula is common, but severe complications requiring intervention are exceedingly rare. Long-term complications such as endocrine and exocrine insufficiency are nearly nonexistent.
CONCLUSIONS: Robotic parenchymal-sparing pancreatectomy appears to have a higher risk of postoperative pancreatic fistula but is rarely associated with severe or long-term complications. Careful patient selection is required to maximize benefits and minimize morbidity.
METHODS: This systematic review consisted of all studies on robotic parenchymal-sparing pancreatectomy (central pancreatectomy, duodenum-preserving partial pancreatic head resection, enucleation, and uncinate resection) published between January 2001 and December 2022 in PubMed and Embase.
RESULTS: A total of 23 studies were included in this review (n = 788). Robotic parenchymal-sparing pancreatectomy is being performed worldwide for benign or indolent pancreatic lesions. When compared to the open approach, robotic parenchymal-sparing pancreatectomies led to a longer average operative time, shorter length of stay, and higher estimated intraoperative blood loss. Postoperative pancreatic fistula is common, but severe complications requiring intervention are exceedingly rare. Long-term complications such as endocrine and exocrine insufficiency are nearly nonexistent.
CONCLUSIONS: Robotic parenchymal-sparing pancreatectomy appears to have a higher risk of postoperative pancreatic fistula but is rarely associated with severe or long-term complications. Careful patient selection is required to maximize benefits and minimize morbidity.
摘要：
背景：保留实质的胰腺切除术方法在技术上具有挑战性，但可以保留正常胰腺并降低术后胰腺功能不全的发生率。机器人平台越来越多地用于这些程序。我们试图评估机器人保留实质的胰腺切除术，并评估其并发症情况和疗效。
方法：本系统综述包括所有关于机器人保留实质胰腺切除术的研究（中央胰腺切除术，保留十二指肠的胰头部分切除术，摘除,和钩部切除术）于2001年1月至2022年12月在PubMed和Embase上发表。
结果：本综述共纳入23项研究（n=788）。在全球范围内，针对良性或惰性胰腺病变正在进行机器人实质保留胰腺切除术。与开放式方法相比，机器人保留实质胰腺切除术导致更长的平均手术时间，停留时间较短，估计术中失血量较高。术后胰瘘很常见，但需要干预的严重并发症极为罕见.长期并发症如内分泌和外分泌功能不全几乎不存在。
结论：机器人保留性胰腺切除术似乎具有较高的术后胰瘘风险，但很少与严重或长期并发症相关。需要仔细选择患者，以最大程度地提高收益并最大程度地降低发病率。
方法：本系统综述包括所有关于机器人保留实质胰腺切除术的研究（中央胰腺切除术，保留十二指肠的胰头部分切除术，摘除,和钩部切除术）于2001年1月至2022年12月在PubMed和Embase上发表。
结果：本综述共纳入23项研究（n=788）。在全球范围内，针对良性或惰性胰腺病变正在进行机器人实质保留胰腺切除术。与开放式方法相比，机器人保留实质胰腺切除术导致更长的平均手术时间，停留时间较短，估计术中失血量较高。术后胰瘘很常见，但需要干预的严重并发症极为罕见.长期并发症如内分泌和外分泌功能不全几乎不存在。
结论：机器人保留性胰腺切除术似乎具有较高的术后胰瘘风险，但很少与严重或长期并发症相关。需要仔细选择患者，以最大程度地提高收益并最大程度地降低发病率。
