HPB : the official journal of the International Hepato Pancreato Biliary Association · 2026
Failure to rescue after pancreatoduodenectomy and the advent of robotic surgery: outcomes across 20 years practice.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Vallorani Alessia, Singh Lavisha, Ganguli Sangrag, Johnson Colin M, Hays Sarah B, Rojas Aram, Mehdi Syed A, Grandhi Miral S, Hogg Melissa E
Аннотация
BACKGROUND: Pancreatoduodenectomy (PD) remains associated with substantial morbidity, but mortality has dropped in specialized centers. Failure to rescue (FTR), defined as mortality following major postoperative complications, has emerged as a key indicator of surgical quality. The influence of surgical approach on FTR remains uncertain.
METHODS: A retrospective review of elective open and robotic PDs performed between 2007 and 2024 at a single high-volume center was conducted. Demographics, comorbidities, operative details, and major complications were analyzed. Rescue interventions included reoperation, interventional radiology, or intensive care unit (ICU) escalation. The primary outcome was ninety-day FTR.
RESULTS: Among 572 open and 140 robotic PDs, median age was 68 years and 50.1% were female. Major complications occurred in 28%. Thirty- and ninety-day mortality were 1.5% and 3%, respectively; FTR was 8.4% (n = 17/202). Compared with open PD, robotic procedures showed fewer major complications (21% vs 30%, p = 0.042) and shorter median hospital stay (7 vs 9 days, p < 0.001). FTR was not influenced by surgical approach, but was associated with higher comorbidity, organ failure and lack of timely ICU escalation.
CONCLUSION: Over nearly two decades, low FTR rates were achieved. Rescue success reflected patient risk, complication severity, and institutional response.
METHODS: A retrospective review of elective open and robotic PDs performed between 2007 and 2024 at a single high-volume center was conducted. Demographics, comorbidities, operative details, and major complications were analyzed. Rescue interventions included reoperation, interventional radiology, or intensive care unit (ICU) escalation. The primary outcome was ninety-day FTR.
RESULTS: Among 572 open and 140 robotic PDs, median age was 68 years and 50.1% were female. Major complications occurred in 28%. Thirty- and ninety-day mortality were 1.5% and 3%, respectively; FTR was 8.4% (n = 17/202). Compared with open PD, robotic procedures showed fewer major complications (21% vs 30%, p = 0.042) and shorter median hospital stay (7 vs 9 days, p < 0.001). FTR was not influenced by surgical approach, but was associated with higher comorbidity, organ failure and lack of timely ICU escalation.
CONCLUSION: Over nearly two decades, low FTR rates were achieved. Rescue success reflected patient risk, complication severity, and institutional response.