Early nationwide experience with robotic versus open lateral pancreaticojejunostomy for symptomatic wide-duct chronic pancreatitis.

IF 3.3 2区医学 Q2 SURGERY

Surgical Endoscopy And Other Interventional Techniques Pub Date : 2026-10-20 DOI:10.1007/s00464-026-13402-3

Emin Kilinc, Charlotte L van Veldhuisen, Charlotte A Leseman, Marja A Boermeester, Stefan A Bouwense, Freek Daams, Joris I Erdmann, J Sven D Mieog, Bert A Bonsing, Bas Groot Koerkamp, Maxime J L Dewulf, Sebastiaan Festen, Hjalmar C van Santvoort, Rogier P Voermans, Roel Haen, Wouter J M Derksen, Olivier R Busch, Marc G Besselink

{"title":"Early nationwide experience with robotic versus open lateral pancreaticojejunostomy for symptomatic wide-duct chronic pancreatitis.","authors":"Emin Kilinc, Charlotte L van Veldhuisen, Charlotte A Leseman, Marja A Boermeester, Stefan A Bouwense, Freek Daams, Joris I Erdmann, J Sven D Mieog, Bert A Bonsing, Bas Groot Koerkamp, Maxime J L Dewulf, Sebastiaan Festen, Hjalmar C van Santvoort, Rogier P Voermans, Roel Haen, Wouter J M Derksen, Olivier R Busch, Marc G Besselink","doi":"10.1007/s00464-026-13402-3","DOIUrl":null,"url":null,"abstract":"Background: Lateral pancreaticojejunostomy (LPJ) is the treatment of choice in patients with symptomatic wide-duct chronic pancreatitis and a normal-size pancreatic head. Adequate pain control in the first days after LPJ via laparotomy is often challenging in these patients due to opioid tolerance resulting from chronic opioid use. Although a robotic approach may improve short-term outcome, comparative multicenter data on robotic versus open LPJ are lacking.Methods: This nationwide multicenter retrospective cohort study included consecutive adults who underwent robotic or open LPJ for symptomatic wide-duct chronic pancreatitis in the Netherlands (2010-2025). Primary outcomes were hospital stay and major complications (Clavien-Dindo grade III or higher).Results: Overall, 133 patients undergoing LPJ were included, of whom 36 (27%) robotic and 97 (73%) open LPJ. The robotic LPJ conversion rate was 0% (0/36). In the overall cohort, 90-day mortality was 0% (0/133) and median hospital stay was 2 days shorter after robotic LPJ (5 [IQR, 4-7] vs 7 [6-10] days; P < 0.001) compared with open LPJ, while the rate of major complications did not differ significantly between groups (36.1% [13/36] vs 26.8% [26/97]; P = 0.405). Blood loss was less with robotic LPJ (100 [IQR, 50-100] vs 300 [125-500] mL; P < 0.001), whereas operative time was comparable (275 [IQR 180-330] vs 232 [188-276] minutes; P = 0.210), and the rate of postoperative pancreatic fistula (POPF) grade B/C was higher (22.2% [8/36] vs 7.2% [7/97]; P = 0.034). The main findings of the overall cohort remained broadly consistent after propensity score matching.Conclusions: In this early nationwide experience, robotic LPJ was associated with shorter hospital stay compared with open LPJ. Although operative time and major complications did not differ significantly between groups, POPF occurred more frequently after robotic LPJ. The potential benefits of robotic LPJ and the possible learning curve effect should be further assessed in randomized trials in experienced centers.","PeriodicalId":22174,"journal":{"name":"Surgical Endoscopy And Other Interventional Techniques","volume":" ","pages":""},"PeriodicalIF":3.3000,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgical Endoscopy And Other Interventional Techniques","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00464-026-13402-3","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Lateral pancreaticojejunostomy (LPJ) is the treatment of choice in patients with symptomatic wide-duct chronic pancreatitis and a normal-size pancreatic head. Adequate pain control in the first days after LPJ via laparotomy is often challenging in these patients due to opioid tolerance resulting from chronic opioid use. Although a robotic approach may improve short-term outcome, comparative multicenter data on robotic versus open LPJ are lacking.

Methods: This nationwide multicenter retrospective cohort study included consecutive adults who underwent robotic or open LPJ for symptomatic wide-duct chronic pancreatitis in the Netherlands (2010-2025). Primary outcomes were hospital stay and major complications (Clavien-Dindo grade III or higher).

Results: Overall, 133 patients undergoing LPJ were included, of whom 36 (27%) robotic and 97 (73%) open LPJ. The robotic LPJ conversion rate was 0% (0/36). In the overall cohort, 90-day mortality was 0% (0/133) and median hospital stay was 2 days shorter after robotic LPJ (5 [IQR, 4-7] vs 7 [6-10] days; P < 0.001) compared with open LPJ, while the rate of major complications did not differ significantly between groups (36.1% [13/36] vs 26.8% [26/97]; P = 0.405). Blood loss was less with robotic LPJ (100 [IQR, 50-100] vs 300 [125-500] mL; P < 0.001), whereas operative time was comparable (275 [IQR 180-330] vs 232 [188-276] minutes; P = 0.210), and the rate of postoperative pancreatic fistula (POPF) grade B/C was higher (22.2% [8/36] vs 7.2% [7/97]; P = 0.034). The main findings of the overall cohort remained broadly consistent after propensity score matching.

Conclusions: In this early nationwide experience, robotic LPJ was associated with shorter hospital stay compared with open LPJ. Although operative time and major complications did not differ significantly between groups, POPF occurred more frequently after robotic LPJ. The potential benefits of robotic LPJ and the possible learning curve effect should be further assessed in randomized trials in experienced centers.

查看原文本刊更多论文

全国范围内机器人与开放式外侧胰空肠吻合术治疗症状性宽管慢性胰腺炎的早期经验。

背景：外侧胰空肠吻合术（LPJ）是症状性宽导管慢性胰腺炎和正常胰头患者的治疗选择。由于慢性阿片类药物使用导致的阿片类药物耐受性，这些患者通过剖腹手术在LPJ术后第一天充分控制疼痛往往具有挑战性。尽管机器人方法可以改善短期结果，但缺乏机器人与开放LPJ的多中心比较数据。方法：这项全国性多中心回顾性队列研究纳入了荷兰（2010-2025）连续接受机器人或开放式LPJ治疗症状性宽管慢性胰腺炎的成年人。主要结局是住院时间和主要并发症（Clavien-Dindo III级或更高）。结果：总共纳入133例接受LPJ的患者，其中36例（27%）为机器人LPJ， 97例（73%）为开放LPJ。机器人LPJ转化率为0%（0/36）。在整个队列中，机器人LPJ术后90天死亡率为0%(0/133)，中位住院时间缩短2天（5 [IQR， 4-7] vs 7[6-10]天）；P结论：在这项早期的全国经验中，与开放式LPJ相比，机器人LPJ与更短的住院时间相关。虽然两组之间的手术时间和主要并发症没有显著差异，但机器人LPJ术后发生POPF的频率更高。机器人LPJ的潜在益处和可能的学习曲线效应应该在有经验的中心的随机试验中进一步评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Surgical Endoscopy And Other Interventional Techniques 医学-外科

CiteScore

6.10

自引率

12.90%

发文量

890

审稿时长

6 months

期刊介绍： Uniquely positioned at the interface between various medical and surgical disciplines, Surgical Endoscopy serves as a focal point for the international surgical community to exchange information on practice, theory, and research. Topics covered in the journal include: -Surgical aspects of: Interventional endoscopy, Ultrasound, Other techniques in the fields of gastroenterology, obstetrics, gynecology, and urology, -Gastroenterologic surgery -Thoracic surgery -Traumatic surgery -Orthopedic surgery -Pediatric surgery