Abstract

Robotic central pancreatectomy withpancreato-jejunal anastomosis (with video)

Machado MA,Surjan R, Makdissi F

J Visc Surg. 2019 Jul 12. pii: S1878-7886(19)30095-5. doi: 10.1016/j.jviscsurg.2019.06.015. [Epub ahead of print]

 

 

PDF (971K)

 

Central pancreatectomy is a pancreas-sparing technique used for benign or low-gradetumors in the neck of the pancreas. This procedure is used to decrease the risk of long-term endocrine and/or exocrine insufficiency. However, most patients that could be a goodcandidate for central pancreatectomy are being treated with distal pancreatectomy withexcess sacrifice of functional pancreas parenchyma and splenectomy. The main reason isthe need for reestablishment of gastrointestinal continuity of the distal pancreas that mayadd significant complexity to this procedure. The fear of higher incidence of pancreaticfistula in this type of surgery, although not confirmed in comparative studies [1], may alsocontribute to fewer indication of central pancreatectomy. The best reconstruction methodafter central pancreatic resection is still to be defined. Pancreatogastrostomy is easier toperform but Roux-en-Y pancreato-jejunostomy may have better long-term pancreatic func-tion [2]. The feasibility of minimally invasive central pancreatectomy was already shown[3]. This video shows a robotic central pancreatectomy in a young patient with solid pseu-dopapillary neoplasm in the neck of the pancreas.