Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis.

Abstract

Chronic pancreatitis is a debilitating, benign inflammatory disorder that significantly alters a patient's quality of life. Pancreatic drainage procedures have long been demonstrated to be safe and feasible using laparoscopic and open surgical approaches but have largely been replaced by pancreaticoduodenectomy. Over the past several decades, perioperative outcomes using the robotic platform in hepatobiliary surgery have been rapidly improving and, in many cases, surpassing outcomes in open and laparoscopic approaches. In appropriately selected patients with pancreatic duct obstruction and without an inflammatory mass at the head of the pancreas, there remains a role for parenchymal-sparing operations that relieve recurrent pancreatitis but also limit endocrine and exocrine insufficiency. We present a robotic-assisted lateral pancreaticojejunostomy for a patient with recurrent pancreatitis in the setting of a pancreatic duct stricture. The intention of this manuscript is to provide fellowship-trained hepatobiliary surgeons with a concise and adoptable method for performing robotic-assisted lateral pancreatojejunostomy. This article demonstrates critical aspects of the operation performed in a minimally invasive, robotic fashion to treat recurrent acute/chronic pancreatitis.