Duodenopancreatectomy for pancreatic tumors - pros and cons

Кригер, А Г; Kаrmаzаnovsky, G. G.; Берелавичус, С. В.; Gorin, D S; Калдаров, А. Р.; Panteleev, V I; Двухжилов, М. В.; Kalinin, D. V.; Глотов, А. В.; Zektser, Vita

doi:10.17116/hirurgia201912128

Khir. Z. im. N.I. Pirogova

2019

DOI: 10.17116/hirurgia201912128

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Duodenopancreatectomy for pancreatic tumors - pros and cons

А Г Кригер

G. G. Kаrmаzаnovsky

С. В. Берелавичус

et al.

Abstract: медицинский исследовательский центр хирургии им. А.В. Вишневского» Минздрава России (дир.-акад. РАН А.Ш. Ревишвили), Москва, Россия; 2 ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» Минздрава России (Сеченовский Университет) (ректор-акад. РАН П.В. Глыбочко), Москва, Россия РЕЗЮМЕ Цель исследования-оптимизация хирургического лечения при множественных и распространенных опухолях поджелудочной железы (ПЖ). Материал и методы. Оперированы 852 больных различными опухолями ПЖ з… Show more

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Method of forming a pancreatogastric anastomosis after pancreatoduodenal resection

Lishchishin¹,

Barishev²,

Petrovsky³

et al. 2021

Ann. hir. gepatol.

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Aim. To evaluate the reproducibility and safety of the developed pancreatogastric anastomosis with various surgical approaches during pancreatoduodenectomy.Materials and methods. The experience of surgical treatment of 47 patients with malignant tumours of the periampullary zone, who underwent pancreatoduodenectomy, was considered. The proposed variant of anastomose was performed to 14 (29.8%) patients: in 7 cases with a minimally invasive approach to perform pancreatoduodenectomy; and in 7 cases with an open approach. To compare retrospectively 33 (70.2%) patients who underwent pancreatogastric anastomosis according to the Bassi technique: 9 – with minimally invasive surgery, 24 – with open surgery. The frequency of pancreatic fistulas, the number of repeated interferences, and hospital mortality were taken into account.Results. A significant advantage of the new method of forming an anastomosis in the duration of the operation was noted in comparison with the Bassi technique. There were no statistically significant differences in blood loss while various types of anastomoses (p > 0.05). When using the proposed technique, the formation of pancreatic fistulas was not revealed. The development of pancreatic fistula was observed in 4 (16.7%) patients after open surgery and in 7 (77.8%) patients after minimally invasive Bassi anastomose formation. Reoperations were performed after open surgery in 3 (12.5%) cases and in 4 (44.4%) cases of minimally invasive surgery according to the Bassi technique. There were 2 (22.2%) deaths in the minimally invasive group.Conclusion. The proposed pancreatogastric anastomosis is applicable in clinical practice. This method allows to create relatively fast and less challenging anastomosis, including with a minimally invasive approach. The use of this technique makes it possible to reduce mortality and postoperative complications in patients with a “complex” pancreas.

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Method of forming a pancreatogastric anastomosis after pancreatoduodenal resection

Lishchishin¹,

Barishev²,

Petrovsky³

et al. 2021

Ann. hir. gepatol.

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Robot-assisted distal pancreatectomy with spleen preservation in the treatment of a child with a solid pseudopapillary tumor

Kozlov,

Poloyan,

Sapukhin

et al. 2024

Russian Journal of Pediatric Surgery, Anesthesia and Intensive

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The use of robots in pancreatic surgery offers several advantages as an adjunct to laparoscopic surgery, including increased maneuverability of robotic instruments and three-dimensional (3D) visualization. To our knowledge, only two cases of robot-assisted distal pancreatectomy with spleen preservation in children have been reported worldwide. In this study, the patient was an 11-year-old boy who was admitted to a children’s hospital with complaints of recurrent upper abdominal pain. He was diagnosed with pancreatic tumor based on ultrasound findings. It was confirmed by magnetic resonance imaging, which revealed a well-defined heterogeneous formation at the border of the body and tail of the pancreas, measuring 2.28 × 2.73 × 2.62 cm with compression of the Wirsung duct. The surgical intervention was performed using a surgical robot VERSIUS (CMR, (UK). Splenic vessels were mobilized carefully, a tourniquet was placed around the body of the pancreas, and it was intersected using a stapler at the border of healthy tissue. The surgical intervention took 340 min, including robot installation time (docking time) of 15 min and a main console time of 325 min. No serious intraoperative complications, such as bleeding or damage to the vascular structures adjacent to the pancreas (branches of the celiac trunk and portal vein), were noted. Histological examination of the tumor confirmed the diagnosis of a solid pseudopapillary tumor. After surgery, the patient’s condition was stable. Recovery proceeded without complications. Magnetic resonance imaging of the abdominal cavity, which was performed 6 months after surgery, revealed no signs of disease recurrence. Robot-assisted surgery is an acceptable alternative to laparoscopic and open surgery for patients with solid pseudopapillary pancreatic tumors because robots offer additional connections, enable closure in improved 3D imaging, increase dexterity when handling instruments, and eliminate of hand tremors.

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Duodenopancreatectomy for pancreatic tumors - pros and cons

Cited by 2 publications

References 17 publications

Method of forming a pancreatogastric anastomosis after pancreatoduodenal resection

Method of forming a pancreatogastric anastomosis after pancreatoduodenal resection

Robot-assisted distal pancreatectomy with spleen preservation in the treatment of a child with a solid pseudopapillary tumor

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