Pancreatoduodenectomy combined with intestinal de-rotation as a complete artery-first approach for inexperienced surgeons

Background:Recent technical advances have reduced the incidence of intraoperative complications associated with pancreatoduodenectomy (PD). We aimed to determine whether inexperienced surgeons (ISs) would be as successful as experienced surgeons (ESs) when performing the complete artery-first approa...

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Published inThe Journal of Medical Investigation Vol. 71; no. 1.2; pp. 75 - 81
Main Authors Morine, Yuji, Saito, Yu, Yamada, Shinichiro, Hiroki, Teraoku, Ikemoto, Tetsuya, Shimada, Mitsuo
Format Journal Article
LanguageEnglish
Published Japan The University of Tokushima Faculty of Medicine 2024
Subjects
Aged
Aged, 80 and over
Clinical Competence
Female
Humans
inexperienced surgeon
inferior pancreatoduodenal artery
Intestines - surgery
Male
Middle Aged
Pancreaticoduodenectomy - adverse effects
Pancreaticoduodenectomy - methods
pancreatoduodenectomy
Postoperative Complications - etiology
superior mesenteric artery
Surgeons
pancreatoduodenectomy
superior mesenteric artery
inexperienced surgeon
inferior pancreatoduodenal artery
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Summary:Background:Recent technical advances have reduced the incidence of intraoperative complications associated with pancreatoduodenectomy (PD). We aimed to determine whether inexperienced surgeons (ISs) would be as successful as experienced surgeons (ESs) when performing the complete artery-first approach using the intestinal de-rotation method of PD. Methods:Seventy patients who underwent PD using the intestinal de-rotation method in Tokushima University Hospital were enrolled in the present study. Intra- and post-operative parameters were compared between patients operated on by ESs (n=20) or ISs (n=50). Results:The surgical procedure lasted longer in the IS group (ES : 402 }68 min vs. IS : 483 }51 min, p<0.0001), but the volume of blood loss was similar (p=0.7304). There was no mortality in either group, and the incidences of postoperative complications with a Clavien-Dindo grade of>III did not differ between the groups. Grade B postoperative pancreatic fistulae developed in 20.0% of patients in the ES group and 22.0% in the IS group (p=0.9569). Finally, the postoperative hospital stay of the IS group (32 }33 days) was equivarent to that of the ES group (33 }16 days) (p=0.9256). Conclusion:ISs were able to perform similarly successful PDs using the intestinal de-rotation method to ESs. J. Med. Invest. 71 : 75-81, February, 2024
ISSN:1343-1420
1349-6867
DOI:10.2152/jmi.71.75