文章：

机器人辅助保留胰腺实质的胰腺切除术：一项系统性综述

Robotic Parenchymal-Sparing Pancreatectomy: A Systematic Review

原文发布日期：1 September 2023

DOI: 10.3390/cancers15174369

类型: Article

开放获取: 是

英文摘要：

Background: Parenchymal-sparing approaches to pancreatectomy are technically challenging procedures but allow for preserving a normal pancreas and decreasing the rate of postoperative pancreatic insufficiency. The robotic platform is increasingly being used for these procedures. We sought to evaluate robotic parenchymal-sparing pancreatectomy and assess its complication profile and efficacy. Methods: This systematic review consisted of all studies on robotic parenchymal-sparing pancreatectomy (central pancreatectomy, duodenum-preserving partial pancreatic head resection, enucleation, and uncinate resection) published between January 2001 and December 2022 in PubMed and Embase. Results: A total of 23 studies were included in this review (n= 788). Robotic parenchymal-sparing pancreatectomy is being performed worldwide for benign or indolent pancreatic lesions. When compared to the open approach, robotic parenchymal-sparing pancreatectomies led to a longer average operative time, shorter length of stay, and higher estimated intraoperative blood loss. Postoperative pancreatic fistula is common, but severe complications requiring intervention are exceedingly rare. Long-term complications such as endocrine and exocrine insufficiency are nearly nonexistent. Conclusions: Robotic parenchymal-sparing pancreatectomy appears to have a higher risk of postoperative pancreatic fistula but is rarely associated with severe or long-term complications. Careful patient selection is required to maximize benefits and minimize morbidity.

摘要翻译： 

背景：胰腺实质保留性切除术在技术上具有挑战性，但能够保留正常胰腺组织并降低术后胰腺功能不全的发生率。机器人手术平台正越来越多地应用于此类手术。本研究旨在评估机器人辅助胰腺实质保留性切除术，并分析其并发症特征及临床疗效。 方法：本系统综述纳入2001年1月至2022年12月期间发表于PubMed和Embase数据库的所有关于机器人辅助胰腺实质保留性切除术（包括胰腺中段切除术、保留十二指肠的胰头部分切除术、肿瘤剜除术及胰钩突切除术）的研究文献。 结果：共纳入23项研究（病例总数n=788）。机器人辅助胰腺实质保留性切除术已在全球范围内应用于良性或惰性胰腺病变的治疗。与开腹手术相比，该术式平均手术时间更长、住院时间更短、术中预估失血量更高。术后胰瘘较为常见，但需要干预的严重并发症极为罕见。内分泌与外分泌功能不全等远期并发症几乎不存在。 结论：机器人辅助胰腺实质保留性切除术虽可能增加术后胰瘘风险，但极少引发严重或远期并发症。通过精细的病例选择可最大化手术获益并降低并发症发生率。

原文链接：

Robotic Parenchymal-Sparing Pancreatectomy: A Systematic Review