Efficacy of pancreaticoduodenectomy by da Vinci robotic surgical system

Objective To investigate the efficacy of pancreaticoduodenectomy by using the da Vinci robotic system.Methods The clinical data of 10 patients who received pancreaticoduodenectomy (PD) by the da Vinci robotic surgical system at the Ruijin Hospital from March 2010 to March 2011 were retrospectively analyzed.The perioperative condition of the patients,incidence of complications and postoperative survival were observed.Results Operations were successfully performed on all the patients,and there was no conversion to open surgery.Nine patients received pancreaticojejunostomy,and 1 received pancreaticogastrostomy.The mean operation time,operative blood loss and postoperative duration of hospital stay were 449.5 minutes (range,405-510 minutes),614 ml (range,340-1100 ml) and 22.7 days (range,14-39 days),respectively.One patient developed pancreatic obstruction which was alleviated by operation.Two patients developed pancreatic fistula and were cured by conservative treatment.One patient developed anastomotic bleeding and was cured by conservative treatment.The results of pathological examination confirmed that 3 patients were diagnosed as with pancreatic ductal adenocarcinoma,2 with duodenal papillary adenocarcinoma,1 with ampullary adenocarcinoma,2 with serous cystadenocarcinoma,1 with carcinoid tumor and 1 with pancreatic duct stone and inflammatory mass.All patients were followed up for 6-12 months.The prognosis of the 9 patients was good,except for 1 patient who had tumor recurrence at the sixth month after operation.No mortality was observed.Conclusion PD performed with the da Vinci robotic surgical system is safe,and its efficacy is comparable to that of open surgery. Key words: Pancreatic neoplasms;  Da Vinci robotic surgical system;  Pancreaticoduodenectomy