Surgery today · 2026
Robotic distal pancreatectomy has a lower incidence than open surgery of clinically relevant pancreatic fistula: a propensity score-matched analysis with emphasis on inflammation and microbial contamination.
СтатьяСравнительное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Suto Hironobu, Matsukawa Hiroyuki, Ando Yasuhisa, Oshima Minoru, Shimizu Yoshio, Fuke Takuro, Nagao Mina, Fujita Koji, Kobayashi Kiyoyuki, Kamada Hideki, Kobara Hideki, Kumamoto Kensuke, Okano Keiichi
Аннотация
PURPOSE: Robotic distal pancreatectomy (RDP) is being adopted increasingly, but its impact on clinically relevant postoperative pancreatic fistula (CR-POPF) compared with that of open distal pancreatectomy (ODP) remains unclear. We compared the incidences of CR-POPF after RDP vs. ODP, focusing on postoperative inflammation and drain bacterial contamination.
METHODS: The subjects of this retrospective analysis were 125 patients who underwent stapler-based distal pancreatectomy at a single center between 2013 and 2025 (RDP, n = 50; ODP, n = 75). Propensity score matching yielded 32 matched patients in each group. Outcomes included CR-POPF, postoperative C-reactive protein, drain amylase levels, and drain fluid cultures on postoperative days (PODs) 1 and 3. Multivariable analysis was performed to identify the factors associated with CR-POPF.
RESULTS: After matching, it was evident that the RDP group had less blood loss (median 95 vs. 573 mL, p < 0.001) and fewer transfusions (3% vs. 19%, p = 0.045). Positive POD-3 drain cultures were less frequent after RDP (6% vs. 25%, p = 0.039). CR-POPF occurred less often after RDP than ODP (6% vs. 41%, p = 0.001). Exploratory analysis revealed that RDP was associated with a lower incidence of CR-POPF, whereas positive POD 3 drain culture was associated with increased risk.
CONCLUSIONS: RDP was associated with a lower incidence of CR-POPF, which may be related to differences in postoperative inflammation and bacterial contamination.
METHODS: The subjects of this retrospective analysis were 125 patients who underwent stapler-based distal pancreatectomy at a single center between 2013 and 2025 (RDP, n = 50; ODP, n = 75). Propensity score matching yielded 32 matched patients in each group. Outcomes included CR-POPF, postoperative C-reactive protein, drain amylase levels, and drain fluid cultures on postoperative days (PODs) 1 and 3. Multivariable analysis was performed to identify the factors associated with CR-POPF.
RESULTS: After matching, it was evident that the RDP group had less blood loss (median 95 vs. 573 mL, p < 0.001) and fewer transfusions (3% vs. 19%, p = 0.045). Positive POD-3 drain cultures were less frequent after RDP (6% vs. 25%, p = 0.039). CR-POPF occurred less often after RDP than ODP (6% vs. 41%, p = 0.001). Exploratory analysis revealed that RDP was associated with a lower incidence of CR-POPF, whereas positive POD 3 drain culture was associated with increased risk.
CONCLUSIONS: RDP was associated with a lower incidence of CR-POPF, which may be related to differences in postoperative inflammation and bacterial contamination.