Robotic pancreatectomy for intraductal papillary mucinous neoplasm of the pancreas: A large-scale study.

BACKGROUND

Intraductal papillary mucinous neoplasm (IPMN) of the pancreas is a mucin-producing tumor that develops from the epithelial lining of the main pancreatic duct or branch pancreatic ducts. Here, we assessed the feasibility and safety of various robotic pancreatectomy approaches to treating IPMN, and short- and long-term outcomes of robotic IPMN resection.

METHODS

Data from patients who underwent robotic pancreatectomy for IPMN between 2012 and 2019 at our hospital were retrospectively analyzed. The survival outcomes for patients were compared using the Kaplan-Meier method and Cox regression analysis.

RESULTS

Of the 174 patients who underwent robotic pancreatectomy, 120 and 54 patients had benign or malignant tumors, respectively. Patients with malignant IPMN had lost more weight in the 6 months prior to surgery (P = .008), and a higher serum level of CA19-9 (P < .001) and CEA (P < .001). Postoperative pancreatic or biliary fistula occurred in 17 or 6 patients overall, respectively. The pathology of the IPMN (P = .030), tumor diameter (P = .016), mural nodule (P = .023), tumor capsule (P = .003) and CA19-9 (P = .024) values were all independent risk factors for survival. The median OS time after surgical resection for the malignant IPMN group was 29.0 months (range, 21.6-36.4). The OS was significantly different in patients with IPMN according to their different pathology, tumor capsule, mural nodule group, CA19-9 level, or tumor diameter.

CONCLUSIONS

This large-scale survey of 174 patients indicated that various robotic pancreatectomy approaches were feasible and safe for IPMN. Patients had an acceptable prognosis, indicating that robotic pancreatectomy represents a feasible potential therapeutic strategy for IPMN.