Comparison of manual sutures and laparoscopic stapler for pancreatic stump closure techniques in robotic distal pancreatectomy: a single-center experience
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Published:2023-12-13
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Volume:
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ISSN:0930-2794
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Container-title:Surgical Endoscopy
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language:en
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Short-container-title:Surg Endosc
Author:
Jiang Qitao,Lu Chao,Zhou Yucheng,Zhu Qicong,Ren Yufeng,Mou Yiping,Jin Weiwei
Abstract
Abstract
Background
Postoperative pancreatic fistulas (POPFs) are prevalent and major postoperative complications of distal pancreatectomy (DP). There are numerous ways to manage the pancreatic stump. However, no single approach has been shown to be consistently superior. Moreover, the potential role of robotic systems in reducing POPFs has received little attention.
Methods
The clinical data of 119 patients who had consecutively received robotic distal pancreatectomy between January 2019 and December 2022 were retrospectively analyzed. Patients were divided into two groups according to the method of handling the pancreatic stump. The attributes of the patients and the variables during the perioperative period were compared.
Results
The analysis included 72 manual sutures and 47 stapler procedures. The manual suture group had a shorter operative time (removing installation time) than the stapler group (125.25 ± 63.04 min vs 153.30 ± 62.03 min, p = 0.019). Additionally, the manual suture group had lower estimated blood loss (50 mL vs 100 mL, p = 0.009) and a shorter postoperative hospital stay. There were no significant differences in the incidence of clinically relevant POPFs between the two groups (18.1% vs 23.4%, P > 0.05). No perioperative death occurred in either group.
Conclusion
The manual suturing technique was shown to have an incidence of POPFs similar to the stapler technique in robotic distal pancreatectomy and to be safe and feasible.
Graphical Abstract
Funder
Medical Science and Technology Project of Zhejiang Province Projects of Zhejiang Provincial Science and Technology
Publisher
Springer Science and Business Media LLC
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