REVO

Less laparoscopic blood loss and equivalent radical treatment, complications, re-admission rate and admission period 

Prof. Kang Chang Moo in Yonsei Cancer Hospital compares and analyzes laparoscopy and ventrotomy

[Hans Economy= Hong Seong Ik, Reporter specializing in health and welfare] It was been revealed that pancreatoduodenectomy using laparoscopy has equivalent surgical effect compared to the existing ventrotomy. 

Pancreatoduodenectomy is a standard surgery method that is conducted on malignant and carcinoid tumor that is created around the ampulla where the bile passage and duodenum in our body meet. 

 ▲ Prof. Kang Chang Moo, performing laparoscopic surgery/Provided by Yonsei University Health System

However, this surgery is complicated due to the complex anatomic structure around the pancreas and duodenum and the remaining pancreas, bile passage and digestive organ that are left after removing tumor have to be reconstructed precisely so it is surgery of high difficulty level. Thus, there are not many medical institutes around the world that have announced large-scale clinical experiences concerning laparoscopic pancreatoduodenectomy. 

Prof. Kang Chang Moo’s team at Yonsei Cancer Hospital Pancreatic and Biliary Tract Cancer Center confirmed that pancreatoduodenectomy using laparoscopy had equivalent surgical effect compared to ventrotomy through 104 clinical

experiences on pancreatoduodenectomy surgeries. 

In detail, 217 patients (113 patients who received ventrotomy surgery, 104 surgeries using laparoscopic surgery) who have received pancreatoduodenectomy surgeries at Yonsei Cancer Hospital from September 2012 to June 2017 were analyzed in order to analyze the safety and feasibility of pancreatoduodenectomy surgery using laparoscopy. 

Through 1:1 propensity score-matched analysis, the demographic materials and surgery results were analyzed retrospectively. In addition, more than 100 previous research results were reviewed. 

In terms of blood loss, laparoscopic surgery had 244.7mL of blood loss while ventrotomy surgery had 548.1mL of blood loss so laparoscopic surgery enabled less blood loss with a small scar. 

Equivalent effects were seen in other areas as well. As for the radical treatment rate which determines the extent of surgical full recovery, it 96.2% for laparoscopy and 99.1% for ventrotomy. As for Postoperative Pancreatic Fistula after surgery, it was 13.5% laparoscopy and 18.8% for ventrotomy. As for re-admission rate, it was 5.8% for laparoscopy and 8% for ventrotomy and as for the admission period after surgery, it was 18.3 days for laparoscopy and 17.9 days for ventrotomy, indicating similar figures. As for 30 day and 90 day death rate, there was no difference in both groups.

Prof. Kang Chang Moo stated that “With regard to patients who are suitable for laparoscopic pancreatoduodenectomy, this surgery exhibits equivalent surgical effects compared to the existing ventrotomy and the advantages of minimally invasive surgery, such as small scar, reduction of pain, fast recovery, drop in blood loss and others can be maximized” and emphasized that “Surgery using laparoscopy would be an good alternative to patients with malignant and carcinoid tumor that is created around the ampulla”.

Prof. Kang Chang Moo has actively been performing over 200 minimally invasive (using laparoscopy and robot) pancreatoduodenectomy surgery including robotic surgery. Recently, he plans to perform pancreatoduodenectomy using ‘Revo-i’, a Korean surgical robot. 

Prof. Kang emphasized that “In particular, Revo-i surgical robot is relatively affordable and at the same time, it is able to maximize the advantages of existing robotic surgeries so it will be a useful surgery to patients who are suitable for pancreatoduodenectomy.” 

Meanwhile, the research result with these details has been published in the online bulletin board of international journey, ‘Surgical Endoscopy’. ‘Surgical Endoscopy’ which specializes in dealing with researches related to minimally invasive surgery is a renowned journal ranking in top 10% of international journals in the field of General Surgery. 

Reporter Hong Seong Ik / hongsi@sporbiz.co.kr 

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