中文｜English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 41 Issue 6
Jun.  2025
Turn off MathJax
Article Contents
Article Navigation >  Journal of Clinical Hepatology  > 2025  >  41(6): 1156-1160

Efficacy of robot-assisted versus laparoscopic parenchymal-sparing pancreatectomy in treatment of pancreatic neuroendocrine neoplasm

DOI: 10.12449/JCH250623

  • Department of General Surgery，Peking Union Medical College Hospital，Peking Union Medical College，Chinese Academy of Medical Sciences，Beijing 100730，China

Research funding:

National Natural Science Foundation of China (82272917);

National High Level Hospital Clinical Research Funding (2022-PUMCH-B-004)

More Information
  • Corresponding author: ZHANG Taiping， tpingzhang@yahoo.com （ORCID： 0000-0003-1689-6908）
  • Received Date: 2024-10-15
  • Accepted Date: 2024-11-29
  • Published Date: 2025-06-25
    Abstract
  •   Objective  To compare and analyze the clinical application of robot-assisted parenchymal-sparing pancreatectomy （R-PSP） and laparoscopic parenchymal-sparing pancreatectomy （L-PSP） in the treatment of pancreatic neuroendocrine neoplasm （pNEN）， and to evaluate the safety and efficacy of the R-PSP procedure.  Methods  A retrospective analysis was performed for the clinical data of pNEN patients who underwent parenchymal-sparing pancreatectomy in Department of General Surgery， Peking Union Medical College Hospital， Peking Union Medical College， Chinese Academy of Medical Sciences， from December 2017 to August 2023， and according to the minimally invasive surgical procedure， they were divided into R-PSP group and L-PSP group. R-PSP and L-PSP were compared in terms of the efficacy of minimally invasive procedure， the outcome of postoperative complications， and oncological efficacy. The independent-samples t test or the Mann-Whitney U test was used for comparison of continuous data between two groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups； the Mann-Whitney U test was used for comparison of ranked data between two groups.  Results  A total of 45 pNEN patients were included， with 9 in the R-PSP group and 36 in the L-PSP group， and there were no significant differences in baseline data between the two groups （all P>0.05）. There were no significant differences between the two groups in time of operation， intraoperative blood loss， intraoperative blood transfusion， and the rate of conversion to laparotomy （all P>0.05）. Compared with the L-PSP group， the R-PSP group had a significantly longer length of postoperative hospital stay ［10.00 （9.00‍ ‍—‍ ‍15.00） days vs 7.50 （6.00‍ ‍—‍ ‍10.00） days， Z=-2.356， P=0.017］ and significantly higher hospital costs ［86 610.44 （81 905.39‍ ‍—‍ ‍114 401.24） yuan vs 38 781.20 （31 708.39‍ ‍—‍ ‍50 514.76） yuan， Z=-4.001， P<0.001］. There were no significant differences between the two groups in the incidence rates of serious postoperative complications （Clavien-Dindo grade ≥Ⅲ）， clinically relevant pancreatic fistula， delayed gastric emptying， and intra-abdominal infection （all P>0.05）. The postoperative 90-day mortality rate was 0% for both groups.  Conclusion  R-PSP has acceptable safety and efficacy in pNEN patients in clinical practice.

     

    • FullText(HTML)
  • loading
    • References(24)
  • [1]
    KORREL M, van HILST J, BOSSCHA K, et al. Nationwide use and outcome of minimally invasive distal pancreatectomy in IDEAL stage IV following a training program and randomized trial[J]. Ann Surg, 2024, 279( 2): 323- 330. DOI: 10.1097/SLA.0000000000005900.
    [2]
    BERARDI G, LUCARINI A, COLASANTI M, et al. Minimally invasive surgery for perihilar cholangiocarcinoma: A systematic review of the short- and long-term results[J]. Cancers(Basel), 2023, 15( 11): 3048. DOI: 10.3390/cancers15113048.
    [3]
    SHAH MH, GOLDNER WS, BENSON AB, et al. Neuroendocrine and adrenal tumors, version 2.2021, NCCN clinical practice guidelines in oncology[J]. J Natl Compr Canc Netw, 2021, 19( 7): 839- 868. DOI: 10.6004/jnccn.2021.0032.
    [4]
    Society of Neuroendocrine Neoplasm of China Anti-Cancer Association. China Anti-Cancer Association guideline for diagnosis and treatment of neuroendocrine neoplasm(2022 edition)[J]. China Oncol, 2022, 32( 6): 545- 580. DOI: 10.19401/j.cnki.1007-3639.2022.06.010.

    中国抗癌协会神经内分泌肿瘤专业委员会. 中国抗癌协会神经内分泌肿瘤诊治指南(2022年版)[J]. 中国癌症杂志, 2022, 32( 6): 545- 580. DOI: 10.19401/j.cnki.1007-3639.2022.06.010.
    [5]
    Study Group of Pancreatic Surgery in China Society of Surgery of Chinese Medical Association, Pancreatic Disease Committee of China Research Hospital Association, Editorial Board of Chinese Journal of Surgery. The guideline for prevention and treatment of common complications after pancreatic surgery(2022)[J]. Chin J Surg, 2023, 61( 7): 529- 534. DOI: 10.3760/cma.j.cn112139-20230419-00173.

    中华医学会外科学分会胰腺外科学组, 中国研究型医院学会胰腺疾病专业委员会, 中华外科杂志编辑部. 胰腺术后外科常见并发症防治指南(2022)[J]. 中华外科杂志, 2023, 61( 7): 529- 534. DOI: 10.3760/cma.j.cn112139-20230419-00173.
    [6]
    WANG XZ, WU WM. Evolution in the surgical treatment concepts of pancreatic neuroendocrine tumors[J]. China Oncol, 2022, 32( 9): 765- 771. DOI: 10.19401/j.cnki.1007-3639.2022.09.002.

    王先泽, 吴文铭. 胰腺神经内分泌肿瘤外科治疗理念的四种转变[J]. 中国癌症杂志, 2022, 32( 9): 765- 771. DOI: 10.19401/j.cnki.1007-3639.2022.09.002.
    [7]
    XU ZH, WANG L, DAI S, et al. Epidemiologic trends of and factors associated with overall survival for patients with gastroenteropancreatic neuroendocrine tumors in the United States[J]. JAMA Netw Open, 2021, 4( 9): e2124750. DOI: 10.1001/jamanetworkopen.2021.24750.
    [8]
    LOU X, QIN Y, XU XW, et al. Spatiotemporal heterogeneity and clinical challenge of pancreatic neuroendocrine tumors[J]. Biochim Biophys Acta Rev Cancer, 2022, 1877( 5): 188782. DOI: 10.1016/j.bbcan.2022.188782.
    [9]
    de PONTHAUD C, MENEGAUX F, GAUJOUX S. Updated principles of surgical management of pancreatic neuroendocrine tumours(pNETs): What every surgeon needs to know[J]. Cancers(Basel), 2021, 13( 23): 5969. DOI: 10.3390/cancers13235969.
    [10]
    YANG JN, ZHANG HR. Research advances in the mechanism of tumor microenvironment and targeted therapy for pancreatic neuroen docrine tumor[J]. J Clin Hepatol, 2023, 39( 8): 2005- 2011. DOI: 10.3969/j.issn.1001-5256.2023.08.036.

    杨佳妮, 张海蓉. 胰腺神经内分泌肿瘤微环境的形成机制及免疫/靶向治疗研究进展[J]. 临床肝胆病杂志, 2023, 39( 8): 2005- 2011. DOI: 10.3969/j.issn.1001-5256.2023.08.036.
    [11]
    DENG XW, SHAO CH. Progress in transformation therapy for pancreatic neuroendocrine neoplasms[J/OL]. Chin J Hepat Surg(Electronic Edition), 2024, 13( 4): 456- 460. DOI: 10.3877/cma.j.issn.2095-3232.2024.04.003.

    邓小巍, 邵成浩. 胰腺神经内分泌肿瘤转化治疗进展[J/OL]. 中华肝脏外科手术学电子杂志, 2024, 13( 4): 456- 460. DOI: 10.3877/cma.j.issn.2095-3232.2024.04.003.
    [12]
    GIULIANI T, de PASTENA M, PAIELLA S, et al. Pancreatic enucleation patients share the same quality of life as the general population at long-term follow-up: A propensity score-matched analysis[J]. Ann Surg, 2023, 277( 3): e609- e616. DOI: 10.1097/SLA.0000000000004911.
    [13]
    BOLM L, NEBBIA M, WEI AC, et al. Long-term outcomes of parenchyma-sparing and oncologic resections in patients with nonfunctional pancreatic neuroendocrine tumors<3 cm in a large multicenter cohort[J]. Ann Surg, 2022, 276( 3): 522- 531. DOI: 10.1097/SLA.0000000000005559.
    [14]
    LIN XC, LIN RG, LU FC, et al. Application value of robot-assisted parenchyma-sparing pancreatectomy[J]. Chin J Dig Surg, 2024, 23( 5): 733- 738. DOI: 10.3760/cma.j.cn115610-20240321-00174.

    林贤超, 林荣贵, 陆逢春, 等. 机器人辅助保留胰腺实质切除术的应用价值[J]. 中华消化外科杂志, 2024, 23( 5): 733- 738. DOI: 10.3760/cma.j.cn115610-20240321-00174.
    [15]
    GIULIANOTTI PC, CORATTI A, ANGELINI M, et al. Robotics in general surgery: Personal experience in a large community hospital[J]. Arch Surg, 2003, 138( 7): 777- 784. DOI: 10.1001/archsurg.138.7.777.
    [16]
    GIULIANOTTI PC, SBRANA F, BIANCO FM, et al. Robot-assisted laparoscopic middle pancreatectomy[J]. J Laparoendosc Adv Surg Tech A, 2010, 20( 2): 135- 139. DOI: 10.1089/lap.2009.0296.
    [17]
    KU G, KANG I, LEE WJ, et al. Revo-i assisted robotic central pancreatectomy[J]. Ann Hepatobiliary Pancreat Surg, 2020, 24( 4): 547- 550. DOI: 10.14701/ahbps.2020.24.4.547.
    [18]
    ZWART MJW, NOTA CLM, de ROOIJ T, et al. Outcomes of a multicenter training program in robotic pancreatoduodenectomy(LAELAPS-3)[J]. Ann Surg, 2022, 276( 6): e886- e895. DOI: 10.1097/SLA.0000000000004783.
    [19]
    FAN SB, HAO H, CHEN SL, et al. Robot-assisted laparoscopic radical prostatectomy using the KangDuo surgical robot system vs the da Vinci Si robotic system[J]. J Endourol, 2023, 37( 5): 568- 574. DOI: 10.1089/end.2022.0739.
    [20]
    LI XS, XU WF, FAN SB, et al. Robot-assisted partial nephrectomy with the newly developed KangDuo surgical robot versus the da Vinci Si surgical system: A double-center prospective randomized controlled noninferiority trial[J]. Eur Urol Focus, 2023, 9( 1): 133- 140. DOI: 10.1016/j.euf.2022.07.008.
    [21]
    MÜLLER PC, BREUER E, NICKEL F, et al. Robotic distal pancreatectomy: A novel standard of care? Benchmark values for surgical outcomes from 16 international expert centers[J]. Ann Surg, 2023, 278( 2): 253- 259. DOI: 10.1097/SLA.0000000000005601.
    [22]
    UIJTERWIJK BA, LEMMERS DHL, BOLM L, et al. Long-term outcomes after laparoscopic, robotic, and open pancreatoduodenectomy for distal cholangiocarcinoma: An international propensity score-matched cohort study[J]. Ann Surg, 2023, 278( 3): e570- e579. DOI: 10.1097/SLA.0000000000005743.
    [23]
    LIU Q, ZHAO ZM, ZHANG XP, et al. Perioperative and oncological outcomes of robotic versus open pancreaticoduodenectomy in low-risk surgical candidates: A multicenter propensity score-matched study[J]. Ann Surg, 2023, 277( 4): e864- e871. DOI: 10.1097/SLA.0000000000005160.
    [24]
    ZHENG R, GHABI E, HE J. Robotic parenchymal-sparing pancreatectomy: A systematic review[J]. Cancers(Basel), 2023, 15( 17): 4369. DOI: 10.3390/cancers15174369.
    • Relative Articles
    • Supplements(0)
    • Cited By
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Tables(2)

    Get Citation
    PDF
    XML

    Article Metrics

    Article views (664) PDF downloads(15) Cited by()
    Proportional views
    Related
        

    The first journal specializing in hepatobiliary and pancreatic diseases in China

    Supervisor：Ministry of Education of the People's Republic of China

    Sponsor：Jilin University

    Academic Support: Chinese Society of Hepatology，Chinese Medical Association

    Address: 461 Xinjiang Road, Changchun

    Submit：0431-88782044

    Peer review：0431-88783542

    Email：lcgdb@vip.163.com

    About Journal

    Submission Guideline

    Journal Online

    Hepatobiliary College

    Guidelines

    YesterdayIP[]YesterdayPV[]TodayIP[]TodayPV[]Online[]

    Website Design © 2020 Editorial Board of Journal of Clinical Hepatology 吉ICP备10000617号-1 Supported by: Beijing Renhe Information Technology Co. Ltd  

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return