title: Robotic-assisted minimally invasive central pancreatectomy: technique and outcomes.
abstract: BACKGROUND
  Central pancreatectomy is a definitive treatment for low-grade tumors of the pancreatic neck that preserves pancreatic and splenic function at the potential expense of postoperative pancreatic fistula. We analyzed outcomes after robot-assisted central pancreatectomy (RACP) to reexamine the risk-benefit profile in the era of minimally invasive surgery.
  
  
  METHODS
  Retrospective analysis of nine RACP performed between August 2009 through June 2010 at a single institution.
  
  
  RESULTS
  The average age of the cohort was 64 (range 18-75 years) with six women (67 %). Indications for surgery included: five benign cystic neoplasm and four pancreatic neuroendocrine tumor. Median operative time was 425 min (range 305-506 min) with 190 ml median blood loss (range 50-350 ml) and one conversion to open due to poor visualization. Median tumor size was 3.0 cm (range 1.9-6.0 cm); all patients achieved R0 status. Pancreaticogastrostomy was performed in seven cases and pancreaticojejunostomy in two. The median length of hospital stay was 10 days (range 7-19). Two clinically significant pancreatic fistulae occurred with one requiring percutaneous drainage. No patients exhibited worsening diabetes or exocrine insufficiency at the 30-day postoperative visit.
  
  
  CONCLUSIONS
  RACP can be performed with safety and oncologic outcomes equivalent to published open series. Although the rate of pancreatic fistula was high, only 22 % had clinically significant events, and none developed worsening pancreatic endocrine or exocrine dysfunction.
authors: Division of Surgical Oncology, Department of Surgery, Loyola University Medical Center, Maywood, IL 60153, USA.
authors: Gerard J
authors: GJ
authors: Abood
authors: M Fatih
authors: MF
authors: Can
authors: Mustapha
authors: M
authors: Daouadi
authors: Harold T
authors: HT
authors: Huss
authors: Jennifer Y
authors: JY
authors: Steve
authors: Lekshmi
authors: L
authors: Ramalingam
authors: Michael
authors: M
authors: Stang
authors: David L
authors: DL
authors: Bartlett
authors: Herbert J
authors: HJ
authors: Zeh
authors: A James
authors: AJ
authors: Moser
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012371:Robotics; D016896:Treatment Outcome