title: Robotic-assisted pancreatic resection: a report of 47 cases.
abstract: BACKGROUND
  There are few reports of robot-assisted pancreatic surgery. Our purpose was to report our surgical and clinical experiences and outcomes of 47 cases of robot-assisted pancreatic resection to show that minimally invasive pancreatic surgery is both feasible and effective.
  
  
  METHODS
  The medical records of 47 patients who underwent robot-assisted pancreatic resections for adenocarcinoma, cystic tumours or other pancreatic diseases at our institution by a single surgical team from March 2010 to December 2011 were retrospectively analysed.
  
  
  RESULTS
  There were 32 females and 15 males with a mean age of 48.7 ± 15.4 years, of whom 13 patients had pathologically diagnosed malignancies, 25 had cystic tumours or chronic pancreatitis, three had solid pseudopapillary tumours of pancreas, and six had other lesions. Sixteen patients underwent pancreatoduodenectomy, 16 distal pancreatectomies (nine of which had spleen resections), 10 middle pancreatectomies, four Beger's procedure, and one had enucleation of a pancreatic lesion. The mean surgical time was 299.2 ± 133.5 (range 70-540) min and mean blood loss was 431.8 ± 309.0 (range 50-1100) ml. Nine patients required a blood transfusion (mean transfusion volume 597.2 ± 543.3 ml). There were no conversions to laparotomy. The mean hospital stay was 29.4 ± 9.1 (range 8-41) days. Pancreatic fistula occurred in 20 cases, anastomotic bleeding in three patients and anastomotic leakage in one patient. Two patients, one who received a PD and one who received a distal pancreatectomy, required a second surgery. All other complications were resolved with conservative management. Surgical margins were negative in all cases, with a postoperative histopathological diagnosis of malignancy. Eleven of the 13 patients with malignancies were alive and well without recurrence at the time of publication, while two patients died.
  
  
  CONCLUSIONS
  Our series of 47 robot-assisted pancreatic resections adds further evidence that this technique is feasible and effective.
authors.affiliation: Department of General Surgery, Ruijin Hospital, Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai Institute of Digestive Surgery, Shanghai, People's Republic of China.
authors.forename: Qian
authors.initials: Q
authors.lastname: Zhan
authors.forename: Xia-Xing
authors.initials: XX
authors.lastname: Deng
authors.forename: Bo
authors.initials: B
authors.lastname: Han
authors.forename: Qin
authors.initials: Q
authors.lastname: Liu
authors.forename: Bai-Yong
authors.initials: BY
authors.lastname: Shen
authors.forename: Cheng-Hong
authors.initials: CH
authors.lastname: Peng
authors.forename: Hong-Wei
authors.initials: HW
authors.lastname: Li
mesh_terms: D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000601:surgery*; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000379:methods*; D016896:Treatment Outcome