Detailed Abstract
[Poster Presentation 6 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP PP 6-S2] Laparoscopic VS Robotic Whipple's Pancreaticoduodenectomy: An Indian Tertiary Care Centre Experience.
Sneh SHETH1, Anand Vijai NATESAN1, Vijayakumar K1, Rajiv MAHARAJ1, Raghunandhan YERRAGUNTLA1, V.P. NALANKILLI1, Senthilnathan PALANISAMY1, Chinnusamy PALANIVELU1
1Department of Liver Transplantation and Hepatobiliary Surgery, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India, India
Background : The safety of minimally invasive pancreaticoduodenectomy has gained increasing support in literature compared to open procedures. However, there is dearth of comparative studies focusing on Laparoscopic versus robotic Pancreaticoduodenectomy. This study seeks to compare the rates of Pancreatic Fistulas and overall complications occurring within 30 days postoperatively between these two surgical approaches.
Methods : The study encompassed patients undergoing Laparoscopic and Robotic Pancreaticoduodenectomy between 2020 and 2023 at GEM hospital Coimbatore and GEM Hospital Chennai. To assess any potential relationship between the type of minimally invasive approach and 30-day overall complications, a multivariable logistic regression model was constructed.
Results : We identified 102 minimally invasive pancreaticoduodenectomy cases, of which 51 (50%) were performed laparoscopically and 51 (50%) robotically. The present analysis did not reveal any significant differences in Open conversion(L-19.6% vs R-13.72%), Mean Blood loss, (L-260 ml vs R-280 ml), No. of Lymph nodes retrieved( L-10.9 vs R-10.14), length of hospital stay(L-9.2 vs R-10.1 days), duration for resumption of oral diet(L-4.2 vs R-4.79 days), Complications like Clinically Relevant –Post-Operative Pancreatic Fistula(L-11.76% vs R-13.72%), Post-pancreatectomy Hemorrhage(L-13.72%, R-15.68%), Surgical site infection(L-17.64% ,R-15.68%), Bile leak(L-5.8% R-5.8%), Reexploration(L-3 vs R-1 patient) and death(1 in each group). Operative times were significantly higher in robotic Pancreaticoduodenectomy ( L-412 vs R-532 mins; p value=0.001).Type of minimally invasive approach (laparoscopic/robotic) was not associated with overall complications. Cost was relatively higher in Robotic group compared to Laparoscopy group.
Conclusions : Robotic Pancreaticoduodenectomy is a feasible and safe procedure in appropriately selected patients. Robotic Pancreaticoduodenectomy could be a viable alternative to the standard laparoscopic procedure. Robotic Pancreaticoduodenectomy though requires longer operative periods, has similar short term post operative outcomes when compared to Laparoscopic Pancreaticoduodenectomy. This study suggests that both minimally invasive approaches have similar outcomes with regard to pancreatic fistula and other postoperative complications & oncological adequacy of resection.
Methods : The study encompassed patients undergoing Laparoscopic and Robotic Pancreaticoduodenectomy between 2020 and 2023 at GEM hospital Coimbatore and GEM Hospital Chennai. To assess any potential relationship between the type of minimally invasive approach and 30-day overall complications, a multivariable logistic regression model was constructed.
Results : We identified 102 minimally invasive pancreaticoduodenectomy cases, of which 51 (50%) were performed laparoscopically and 51 (50%) robotically. The present analysis did not reveal any significant differences in Open conversion(L-19.6% vs R-13.72%), Mean Blood loss, (L-260 ml vs R-280 ml), No. of Lymph nodes retrieved( L-10.9 vs R-10.14), length of hospital stay(L-9.2 vs R-10.1 days), duration for resumption of oral diet(L-4.2 vs R-4.79 days), Complications like Clinically Relevant –Post-Operative Pancreatic Fistula(L-11.76% vs R-13.72%), Post-pancreatectomy Hemorrhage(L-13.72%, R-15.68%), Surgical site infection(L-17.64% ,R-15.68%), Bile leak(L-5.8% R-5.8%), Reexploration(L-3 vs R-1 patient) and death(1 in each group). Operative times were significantly higher in robotic Pancreaticoduodenectomy ( L-412 vs R-532 mins; p value=0.001).Type of minimally invasive approach (laparoscopic/robotic) was not associated with overall complications. Cost was relatively higher in Robotic group compared to Laparoscopy group.
Conclusions : Robotic Pancreaticoduodenectomy is a feasible and safe procedure in appropriately selected patients. Robotic Pancreaticoduodenectomy could be a viable alternative to the standard laparoscopic procedure. Robotic Pancreaticoduodenectomy though requires longer operative periods, has similar short term post operative outcomes when compared to Laparoscopic Pancreaticoduodenectomy. This study suggests that both minimally invasive approaches have similar outcomes with regard to pancreatic fistula and other postoperative complications & oncological adequacy of resection.
SESSION
Poster Presentation 6
Zone G 3/21/2024 2:50 PM - 3:30 PM