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Surgical Endoscopy

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23-01-2023 | Laparotomy | Original Article

Identifying the preoperative factors predicting the surgical difficulty of robotic distal pancreatectomy

Authors: Qiang Xu, Pengyu Li, Hanyu Zhang, Mengyi Wang, Qiaofei Liu, Wenjing Liu, Menghua Dai

Published in: Surgical Endoscopy | Issue 5/2023

Abstract

Background

Few studies have evaluated the preoperative factors predicting the surgical difficulty of robotic distal pancreatectomy (RDP). This study aims to explore such factors and provide guidance on the selection of suitable patients to aid surgeons lacking extensive experience in RDP.

Methods

A retrospective study was conducted on consecutive patients who underwent RDP to identify preoperative factors predicting surgical difficulty. High surgical difficulty was defined by both operation time and intraoperative estimated blood loss exceeding their median, or by conversion to laparotomy.

Results

A total of 161 patients were ultimately enrolled, including 51 patients with high levels of surgical difficulty. Multivariate analysis revealed that male sex [OR (95% CI): 4.07 (1.77,9.40), p = 0.001], body mass index (BMI) ≥ 25 kg/m² OR (95% CI): 2.27 (1.03,5.00), p = 0.042], tumors located at the neck of the pancreas [OR (95% CI): 4.15 (1.49,11.56), p = 0.006] and splenic artery type B [OR (95% CI): 3.28 (1.09,9.91), p = 0.035] were independent risk factors for surgical difficulty. Regarding postoperative complications, high surgical difficulty was associated with the risk of overall complications and pancreatic fistula (grade B/C) (49.0% vs. 22.7%, p < 0.001; 39.2% vs. 19.1%, p = 0.006).

Conclusion

Male sex, body mass index ≥ 25 kg/m2, tumor located at the neck of the pancreas and splenic artery type B are associated with a high RDP difficulty level. These factors can be used preoperatively to assess the difficulty level of surgery, to help surgeons choose patients suitable for them and ensure surgical safety.

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Title: Identifying the preoperative factors predicting the surgical difficulty of robotic distal pancreatectomy
Authors: Qiang Xu
Pengyu Li
Hanyu Zhang
Mengyi Wang
Qiaofei Liu
Wenjing Liu
Menghua Dai
Publication date: 23-01-2023
Publisher: Springer US
Keywords: Laparotomy
Pancreatectomy
Laparotomy
Published in: Surgical Endoscopy / Issue 5/2023
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-023-09865-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Identifying the preoperative factors predicting the surgical difficulty of robotic distal pancreatectomy

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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