Participants should be aware of the following financial/non-financial relationships:
ALI AHMAD, MD, FACS: Intuitive Surgical (Individual(s) Involved: Self): Speaker/Honoraria
Introduction: Management of a soft non-dilated pancreas during pancreaticoduodenectomy (PD) is challenging. Various techniques have been described in literature. However with minimally invasive approach, replication of such techniques can be challenging. We demonstrate our technique for externalized pancreatic stent during robotic PD.
Methods: Patient with a well differentiated neuroendocrine tumor underwent robotic PD. The pancreas was found to be a soft gland with a non-dilated small pancreatic duct. Our technique demonstrates reconstruction of such a gland to minimize the potential of post-operative pancreatic fistula.
Results: This technique can be replicated with ease. Externalized stenting has been described in literature for open approach. Our technique offers the reproducibility of this option for pancreatico-jejunostomy anastomosis in robotic PD. Patient had an uneventful recovery and was discharged home on postoperative day 5 without any evidence of postoperative pancreatic fistula.
Conclusions: Externalized pancreatic stent during robotic PD can be accomplished safely and offers a viable option during pancreatico-jejunostomy reconstruction especially for a soft non-dilated pancreas.
Learning Objectives:
Describe the technique for externalized pancreatic stent
Demonstrate an understanding of the need for this technique as an option during robotic pancreaticoduodenectomy
Demonstrate the concern for postoperative pancreatic fistula in soft non-dilated pancreas reconstruction.
