Retrocolic versus antecolic gastrointestinal reconstruction in robotic pancreaticoduodenectomy.

J Hepatobiliary Pancreat Sci 2019 Nov 8;26(11):517-523. Epub 2019 Oct 8.

Second Department of Hepatopancreatobiliary Surgery, Chinese People's Liberation Army (PLA) General Hospital, 28 Fuxing Road, Haidian District, Beijing, 100853, China.

Background: With the advancement of robotic pancreaticoduodenectomy (RPD), several reconstruction methods have been advocated to make RPD more effective and safer. In this study, we investigated the safety and effectiveness of RPD using a left retrocolic (L-port) technique and compared it with those of RPD using an antecolic technique.

Methods: Between October 2015 and August 2016, we retrospectively reviewed consecutive cases of RPD before and after introducing the L-port technique for gastrointestinal reconstruction. The L-port technique was mainly performed for retrocolic gastrojejunal reconstruction and some cases of duodenojejunal reconstruction. The perioperative and postoperative outcomes were compared in the two groups.

Results: Eighty-three cases of RPD were retrieved for statistical analysis. Compared with the antecolic group, the L-port group was significantly associated with a shorter operative time (median time [IQR] 345 [307-384] min vs. 390 [370-455] min, P < 0.001), reconstruction time (54 [48-59] min vs. 84 [75-98] min, P < 0.001) and lower incidence of delayed gastric emptying. There were no cases of re-operation due to internal herniation, colonic ischemia, or bowel volvulus in the L-port group during the 1-year follow-up period.

Conclusions: Our results demonstrated that the L-port technique of RPD is a safe and feasible technique for gastrointestinal reconstruction.

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http://dx.doi.org/10.1002/jhbp.670DOI Listing
November 2019
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References

(Supplied by CrossRef)
Robotic pancreaticoduodenectomy for pancreatic adenocarcinoma: role in 2014 and beyond
Baker EH et al.
J Gastrointest Oncol 2015

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