达芬奇机器人在胰腺手术中的应用OACSTPCD

Objective:To analyze the safety and feasibility of da Vinci robot in minimally invasive pancreatic surgery.Methods:The clinical data of 42 patients who underwent da Vinci robotic pancreatic surgery from Dec.2019 to Dec.2022 were retro-spectively analyzed and compared with 149 laparoscopic pancreatic minimally invasive surgeries in the same period.In the robotic group,there were 10 cases of pancreaticoduodenectomy,24 cases of distal pancreatectomy,5 cases of local resection of pancreatic tumor,and 3 cases of mid-pancreatic resection;in the laparoscopic group,there were 98 cases of pancreaticoduodenectomy,31 cases of distal pancreatectomy,2 cases of local resection of pancreatic tumor,and 18 cases of mid-pancreatic resection.Results:In pancreati-coduodenectomy,the operation time in the robotic group was longer than that in the laparoscopic group[(383.2±69.6)min vs.(307.1±73.2)min,P<0.05];and the postoperative exhaust time was shorter than that in the laparoscopic group[(3.1±0.7)d vs.(4.0±1.0)d,P<0.05];in the two groups,B+C grade pancreatic fistula(0 vs.10.2%),postoperative hemorrhage(10.0%vs.4.1%),postopera-tivelymphaticfistula(10.0%vs.5.1%),abdominal infection(0 vs.5.1%),and pulmonary infection(0 vs.4.1%)incidences were not statistically significantly different(P>0.05).In distal pancreatectomy,intraoperative blood loss in the robotic group was less than that in the laparoscopic group[(106.7±59.6)mL vs.(168.1±90.9)mL,P<0.05],and postoperative exhaust time was shorter than that in the laparoscopic group[(3.5±0.9)d vs.(4.7±1.3)d,P<0.05].The differences in the incidence of grade B+C pancre-atic fistula(8.3%vs.9.7%),abdominal infection(4.2%vs.9.7%),and incision infection(4.2%vs.0)were not statistically significant(P>0.05).In benign or borderline tumor surgery,the spleen preservation rate was higher in the robotic group than that in the laparoscopic group(65.0%vs.34.6%,P=0.041).Conclusions:Robotic pancreatic surgery is safe and feasible,with a complica-tion rate comparable to laparoscopic pancreatic surgery,and has certain advantages in spleen preservation rate of distal pancreatectomy and the first postoperative exhaust time.