title: Robot-Assisted Middle Pancreatectomy for Elderly Patients: Our Initial Experience.
abstract: BACKGROUND
  The aim of this study was to evaluate the indications, safety, feasibility, and short- and long-term outcomes for elderly patients who underwent robot-assisted middle pancreatectomies (MPs).
  
  
  METHODS
  Ten patients (≥60 years) underwent robot-assisted middle pancreatectomies from 2012 to 2015. The perioperative data, including tumor size, operating time, rate of postoperative pancreatic fistula (POPF), postoperative morbidity, and other parameters, were analyzed. We collected and analyzed the follow-up information.
  
  
  RESULTS
  The mean age of patients was 64.30 years (range, 60-73 years). The average tumor size was 2.61 cm. The 10 cases were all benign or low-grade malignant lesions. The mean operating time was 175.00 min. The mean blood loss was 113.00 ml with no blood transfusion needed. Postoperative fistulas developed in 5 patients; there were 2 Grade A fistulas and 3 grade B fistulas. There were 3 patients who underwent postoperative complications, including 2 Grade 1 or 2 complications and 1 Grade 3 complication. No reoperation and postoperative mortality occurred. The mean hospital stay was 19.91 days. After a median follow-up of 23 months, new onset of diabetes mellitus developed in 1 patient and none suffered from deterioration of previously diagnosed diabetes or exocrine insufficiency, and no tumor recurrence happened.
  
  
  CONCLUSIONS
  Robot-assisted middle pancreatectomy was safe and feasible for elderly people. It had low risk of exocrine or endocrine dysfunction and benefited patients' long-term outcomes. Incidence of POPF was relatively high but we could prevent it from resulting in bad outcomes by scientific perioperative care and systemic treatment.
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Tian
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Xinjing
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Zhen
authors.initials: Z
authors.lastname: Huo
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Chenlei
authors.initials: C
authors.lastname: Wen
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Zhichong
authors.initials: Z
authors.lastname: Wu
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Jiabin
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Dongfeng
authors.initials: D
authors.lastname: Cheng
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Xiaxing
authors.initials: X
authors.lastname: Deng
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Baiyong
authors.initials: B
authors.lastname: Shen
authors.affiliation: Department of General Surgery, Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China (mainland).
authors.forename: Chenghong
authors.initials: C
authors.lastname: Peng
mesh_terms: D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010179:Pancreas / Q000601:surgery*; D010180:Pancreatectomy / Q000379:methods*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures; D016896:Treatment Outcome