Robotic distal pancreatectomy: experience in a high-volume center

Abstract

Background: Robotic distal pancreatectomy (RDP) has become widely applied in the treatment of tumors of the pancreatic body and tail. This study aimed to evaluate the clinical outcomes of RDP in a high-volume robotic center. Methods: All patients, who underwent RDP in our department from November 2011 to August 2016, were identified through electronic databases. Their baseline characteristics and perioperative outcomes were analyzed. Results: A total of 210 patients (74 men and 136 women; mean age, 48.3±15.4 years) were included in the study. The mean largest tumor diameter was 2.5 cm. The mean operative time was 159.8 minutes, and the median estimated blood loss (EBL) was 161.2±262.2 mL. Ten (4.8%) patients required conversion to laparotomy or blood transfusion. Postoperative morbidities occurred in 34 patients (16.2%). The spleen (SP) and splenic vessels preservation (SVP) rates in patients without malignancy were 81.7% (98/120) and 35% (42/120), retrospectively. The mean postoperative hospital stay was 8.5 days. On histopathological examination: pancreatic adenocarcinoma (PDAC) (73, 34.8%), serous cystadenoma (29, 13.8%), mucinous cystadenoma (33, 15.7%), mucinous cystadenocarcinoma (8, 3.8%), solid-pseudopapillary tumor (32, 15.2%), neuroendocrine tumor (23, 11.0%), pancreatic pseudocyst (8, 3.8%) intraductal papillary mucinous neoplasm (4, 1.9%). Conclusions: This case series demonstrates that RDP is safe and feasible. However, cost-effectiveness of RDP must be evaluated and the best indications should be defined.