TY - JOUR
T1 - Minimally Invasive Spleen-Preserving Distal Pancreatectomy in Obese Patients
T2 - Factors Related to Clinically Relevant Pancreatic Fistula
AU - Ausania, Fabio
AU - Landi, Filippo
AU - González-Abós, Carolina
AU - Martinie, John B.
AU - Vrochides, Dionisios
AU - Walsh, Matthew
AU - Hossain, Shanaz M.
AU - White, Steven
AU - Prabakaran, Viswakumar
AU - Melstrom, Laleh G.
AU - Fong, Yuman
AU - Butturini, Giovanni
AU - Bignotto, Laura
AU - Valle, Valentina
AU - Bing, Yuntao
AU - Xiu, Dianrong
AU - Franco, Gregorio Di
AU - Sanchez-Bueno, Francisco
AU - de'Angelis, Nicola
AU - Laurent, Alexis
AU - Giuliani, Giuseppe
AU - Pernazza, Graziano
AU - Esposito, Alessandro
AU - Salvia, Roberto
AU - Bazzocchi, Francesca
AU - Esposito, Ludovica
AU - Pietrabissa, Andrea
AU - Pugliese, Luigi
AU - Rios, José
AU - Coratti, Andrea
AU - Morelli, Luca
AU - Giulianotti, Pier C.
N1 - Publisher Copyright:
© 2025 The Author(s). The International Journal of Medical Robotics and Computer Assisted Surgery published by John Wiley & Sons Ltd.
PY - 2025/7/8
Y1 - 2025/7/8
N2 - Background: Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP. Methods: A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods. Results: Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; p = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; p = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates. Discussion: Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.
AB - Background: Minimally invasive spleen-preserving distal pancreatectomy (MI-SPDP) provides superior outcomes compared with open surgery, with robotic techniques showing better short-term results than laparoscopic techniques, particularly in obese patients. This study aimed to evaluate the impact of the surgical approach on postoperative pancreatic fistula (POPF) incidence in obese patients undergoing MI-SPDP. Methods: A retrospective analysis of obese patients from 16 international centres compared robotic (R-SPDP) and laparoscopic (L-SPDP) approaches. Perioperative outcomes and factors associated with clinically relevant POPF were analysed using univariate and multivariate methods. Results: Among 130 patients (57L-SPDP, 73R-SPDP), POPF incidence was significantly lower in the robotic group (15.1% vs. 42.1%; p = 0.001). The Comprehensive Complications Index was also lower (8% vs. 15%; p = 0.002). Laparoscopic approach (OR = 4.0), pancreatic body transection (OR = 2.6), and non-stapler stump closure (OR = 3.2) were independently associated with higher POPF rates. Discussion: Robotic MI-SPDP reduces POPF in obese patients. Transection at the pancreatic neck and stapler-based closure can improve outcomes.
KW - laparoscopic distal pancreatectomy
KW - obesity
KW - postoperative pancreatic fistula
KW - robotic distal pancreatectomy
KW - spleen-preservation pancreatectomy
UR - https://www.scopus.com/pages/publications/105009910272
UR - https://www.mendeley.com/catalogue/f11a3f36-8d4d-3ba7-84fe-66ece5e31cbf/
U2 - 10.1002/rcs.70091
DO - 10.1002/rcs.70091
M3 - Article
C2 - 40629718
AN - SCOPUS:105009910272
SN - 1478-5951
VL - 21
JO - International Journal of Medical Robotics and Computer Assisted Surgery
JF - International Journal of Medical Robotics and Computer Assisted Surgery
IS - 4
M1 - e70091
ER -
