Charnwit Assawasirisin, Youngmin Han, Hye-Sol Jung, Won-Gun Yun, Yoon Soo Chae, Wooil Kwon, Joon Seong Park, Jin-Young Jang
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引用次数: 0
摘要
背景：机器人辅助胰十二指肠切除术（RPD）具有人体工程学优势，但其对胰瘘风险的影响尚不清楚。本研究使用替代瘘管风险评分（aFRS）评估RPD的安全性。方法：我们回顾性回顾了首尔国立大学医院（Seoul National University Hospital）的胰十二指肠切除术数据库（2014-2023），以1:1的aFRS概率匹配分析比较RPD和开放式胰十二指肠切除术（OPD）。基线特征和结果进行总体比较，并按aFRS风险组进行比较。结果：在匹配的队列中，与OPD相比，RPD患者具有相似的BMI，但胰腺质地柔软，导管较小，aFRS发生率更高。总体而言，临床相关的术后胰瘘（CR-POPF）发生率相似（11%对10%，p = 0.84）。然而，RPD的胃排空延迟率较低（3.1%对5.4%,p = 0.024），伤口并发症发生率较低（1.9%对5.5%,p）。结论：RPD是一种安全可行的方法，在减少高危患者的CR-POPF方面具有特别的益处。
Comparison of Pancreatic Fistula Between Robotic-Assisted and Open Pancreatoduodenectomy: A Comprehensive Evaluation Using an Alternative Fistula Risk Score.
Background: Robotic-assisted pancreatoduodenectomy (RPD) offers ergonomic advantages, yet its effect on pancreatic fistula risk remains unclear. This study evaluated RPD safety using the alternative fistula risk score (aFRS).
Methods: We retrospectively reviewed the pancreatoduodenectomy database at Seoul National University Hospital (2014-2023), comparing RPD with open pancreatoduodenectomy (OPD) in a 1:1 aFRS probability-matched analysis. Baseline characteristics and outcomes were compared overall and by aFRS risk groups.
Results: In the matched cohort, RPD patients had a similar BMI but a higher incidence of soft pancreatic texture, smaller ducts, and increased aFRS probability compared to OPD. Overall, clinically relevant postoperative pancreatic fistula (CR-POPF) rates were similar (11% vs. 10%, p = 0.84). However, RPD had lower rates of delayed gastric emptying (3.1% vs. 5.4%, p = 0.024) and wound complications (1.9% vs. 5.5%, p < 0.001). Notably, in the high-risk aFRS group, RPD demonstrated significantly lower CR-POPF rates both before (12% vs. 18%, p = 0.049) and after matching (11% vs. 17%, p = 0.042).
Conclusion: RPD is a safe and feasible approach, offering particular benefits in reducing CR-POPF among high-risk patients.
期刊介绍：
The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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