Application of da Vinci Surgical System in Senile Patients with Severe Obstructive Jaundice_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DING Lei ¹ , CHEN Junzhou ² , ZHANG Tao ² , FANG Jingjing ³ , ZHOU Ningxin. ²

1. Licentiate Training Base for Liaoning Medical College,General Hospital of The Second Artillery Corps of Chinese PLA, Beijing 100088, China;;
2. Institute of Hepatobiliary Gastrointestinal Disease, General Hospital of The Second Artillery Corps of Chinese PLA, Beijing 100088, China;;
3. Licentiate Training Base for Suzhou University, General Hospital of The Second Artillery Corps of Chinese PLA, Beijing 100088, China;

Corresponding author：

Keywords：

da Vinci surgical system; Senile; Severe obstructive jaundice; Minimally invasive; Hepatobiliary pancreatic surgery

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective 　To summarize the clinical experience of da Vinci surgical system in treatment for senile patients with severe obstructive jaundice．
Methods 　From January 2009 to May 2011, 209 patients with hepatopancreatobiliary （HPB） diseases underwent robotic surgeries by using da Vinci surgical system. Forty-seven senile patients with severe obstructive jaundice were selected for robotic surgery （robot group） and 44 for open surgery（open group）.The distribution of disease, pro-, intra-, and post-operative data in the two groups were analyzed.
Results 　Baseline of two groups was same. A total of 46 patients had underwent total robotic surgeries （97.87%，46/47） and 1 patient converted to hand-assisted procedure （2.13%，1/47）. Surgeries included all HPB difficult surgical procedures, also including 1 case of hilar cholangiocarcinoma patient who had high level serum bilirubin （375μmol/L）and underwent emergency resection for hilar cholangiocarcinoma and portal-jejunal Roux-en-Y anastomosis． Postoperative complications occurred in 7 cases （14.89%, 7/47） and 1 case died （2.13%, 1/47） . Three-month survival rate was 78.15%. Fifteen-day and 3-month after surgery, physical strength score was 42.87±18.61 and 58.51±23.86, respectively. The total length of abdominal incision was （6.30±1.70） cm. All the patients in the open group completed surgery, including emergency operation in 4 cases. Postoperative complications occurred in 13 cases （29.55%, 13/44） and 2 cases died （4.55%, 2/44）.Three-month survival rate was 72.36%. Fifteen-day and 3-month after surgery, physical strength score was 37.15±13.64 and 45.27±18.96, respectively. The total length of abdominal incision was （26.73±3.07） cm. There were significant differences of postoperative complications, postoperative 15-day and 3-month physical strength score, and incision length between two groups（P＜0.05）.
Conclusions 　da Vinci surgical system is safe and effective in treatment for senile patients with severe obstructive jaundice.

Citation： DING Lei,CHEN Junzhou,ZHANG Tao,FANG Jingjing,ZHOU Ningxin.. Application of da Vinci Surgical System in Senile Patients with Severe Obstructive Jaundice. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2012, 19(2): 171-176. doi: Copy

1.	朱文俊 ,熊奇如 .恶性梗阻性黄疸的外科诊疗现状[ J].肝胆外科杂志 , 2010, 18(2)：154-156.
2.	张声定 . 梗阻性黄疸 120例临床分析[ J]. 中国现代医生 , 2010, 48(2)：107-108.
3.	刘祖军,赫军,伍松合,等.老年梗阻性黄疸 47例临床分析[ J]. 右江医学 , 2003, 31(4)：342-343.
4.	缪林, 刘政, 黄光明, 等. 老年梗阻性黄疸 30例诊治体会[ J].实用老年医学 , 2001, 15(6)：327-328.
5.	陈军周 ,周宁新 ,刘全达 ,等 .达芬奇机器人手术系统再手术入路的选择[ J]. 中华消化外科杂志 , 2010, 9(2)：105-108.
6.	王宁华. 疼痛定量评定的进展[J]. 中国临床康复 , 2002, 6(18)：2738-2739.
7.	Kaasa T, Wesssl J. The Edmonton Functional Assessment Tool： further development and validation for use in palliative care[J]. J Palliative Care, 2001, 17：5-11.
8.	Andereggen E, Ris F, Gervaz P，et al. Outcome of surgery for rectal cancer in octogenarians[J]. Swiss Med Wkly, 2006, 136(11-12)：185-188.
9.	Etzioni DA, Liu JH, Maggard MA，et al. The aging population and its impact on the surgery workforce[J]. Ann Surg, 2003, 238(2)：170-177.
10.	陈宝公，刘家治 ,郝明利 ,等 .老年外科的有关问题[J].普外临床 , 1994, 2(2)：90-92.
11.	Janssen-Heijnen ML, Maas HA, Houterman S, et al. Comorbidity in older surgical cancer patients：influence on patient care and outcome[J]. Eur J Cancer，2007, 43(15)：2179-2193.
12.	Janssen-Heijnen ML, Houterman S, Lemmens VE，et al. Prognostic impact of increasing age and co-morbidity in cancer patients：a population-based approach[J]. Crit Rev Oncol Hematol, 2005, 55(3)：231-240.
13.	Perseus J, Cornelius A，Meier J, et al. Tumor-induced occlusive jaundice-strategy of interventional drainage techniques[J]. Rontgenpraxis, 1995, 48(6)：170-174.
14.	廖文张 . 92例老年人胆道感染的急诊诊治[J]. 医学临床研究 , 2007, 24(11)：1962-1963.
15.	曲永利 .手术治疗老年急性重症胆管炎体会[J].实用医药杂志, 2008, 25(8)：936-937.
16.	吴在德 ,吴肇汉 .外科学[M] .北京：人民卫生出版社 , 2003： 581.
17.	周宁新，万涛 . 肝胆管结石病的外科治疗决策[J]. 中国实用外科杂志 , 2004, 24(2)：69-70.
18.	Rosen M, Ponsky J. Minimally invasive surgery[J].Endoscopy, 2001, 33(4)：358-366.
19.	Akiyoshi T, Kuroyanagi H, Oya M, et al. Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients：is it safe and beneficial?[J]. J Gastrointest Surg, 2009, 13(9)：1614-1618.
20.	杜祥民 , 张永寿 . 达芬奇手术机器人系统介绍及应用进展[J] . 中国医学装备 , 2011, 8(5)：60-63.
21.	Vignali A, Di Palo S, Tamburini A, et al. Laparoscopic vs. open colectomies in octogenarians：a case-matched control study[J]. Dis Colon Rectum, 2005, 48(11)：2070-2075.
22.	Chautard J, Alves A, Zalinski S, et al. Laparoscopic colorectal surgery in elderly patients：a matched case-control study in 178 patients[J]. J Am Coll Surg, 2008, 206(2)：255-260.
23.	Senagore AJ, Madbouly KM, Fazio VW, et al. Advantages of laparoscopic colectomy in older patients[J]. Arch Surg, 2003, 138(3)：252-256.
24.	Cheung HY, Chung CC, Fung JT, et al. Laparoscopic resection for colorectal cancer in octogenarians：results in a decade[J]. Dis Colon Rectum, 2007, 50(11)：1905-1910.
25.	Ceulemans R, Al-Ahdab N, Leroy J, et al. Safe laparoscopic surgery in the elderly[J]. Am J Surg, 2004, 187(3)：323-327.
26.	Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection－2 804 patients[J]. Ann Surg, 2009, 250(5)：831-841.
27.	Gagner M, Palermo M. Laparoscopic Whipple procedure：review of the literature[J]. J Hepatobiliary Pancreat Surg, 2009, 16(6)： 726-730.
28.	周宁新 .达芬奇机器人手术系统带给我们的挑战与启迪[J] .中华消化外科杂志 , 2010, 9(2)：90-92.
29.	Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy[J]. Surg Endosc, 1994, 8(5)：408-410.
30.	Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy：feasibility and outcome in an early experience[J]. Arch Surg, 2010, 145(1)：19-23.
31.	郑民华 .腹腔镜在胰十二指肠切除术中的应用与评价[J].中国微创外科杂志 , 2006, 6(1)：5-7.
32.	Urbach DR, Swanstrom LL, Hansen PD. The effect of laparoscopy on survival in pancreatic cancer[J]. Arch Surg, 2002, 137(2)： 191-199.
33.	Milone L, Turner P, Gagner M. Laparoscopic surgery for pancreatic tumors, an uptake[J]. Minerva Chir, 2004, 59(2)：165-173.
34.	Palanivelu C, Jani K, Senthilnathan P, et al. Laparoscopic pancreaticoduodenectomy：technique and outcomes[J]. J Am Coll Surg, 2007, 205(2)：222-230.
35.	Palanivelu C, Rajan PS, Rangarajan M, et al. Evolution in techniques of laparoscopic pancreaticoduodenectomy：a decade long experience from a tertiary center[J]. J Hepatobiliary Pancreat Surg, 2009, 16(6)：731-740.
36.	Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases[J]. Surg Endosc, 2006, 20(7)：1045-1050.
37.	Pugliese R, Scandroglio I, Sansonna F, et al. Laparoscopic pancreaticoduodenectomy：a retrospective review of 19 cases[J]. Surg Laparosc Endosc Percutan Tech, 2008, 18(1)：13-18.
38.	Gagner M, Pomp A. Laparoscopic pancreatic resection：Is it worthwhile?[J]. J Gastrointest Surg, 1997, 1(1)：20-25.
39.	Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery：personal experience in a large community hospital[J]. Arch Surg, 2003, 138(7)：777-784.
40.	Nicolas B, Pietro A, Francesco B, et al．Safety of robotic general surgery in elderly patients[J]. J Robotic Surg, 2010, 4(2)：9198.
41.	Buchs NC, Addeo P, Bianco FM, et al. Outcomes of robot-assisted pancreaticoduodenectomy in patients older than 70 years： a comparative study[J]. World J Surg, 2010, 34(9)：2109-2114.
42.	Krohn BG，Kay JH, Mendez MA, et al. Rapid sustained recovery after cardiac operations[J]. Thorac Cardiovasc Surg, 1990, 100(2)：194-197.
43.	Delaney CP, Fazio VW, Senagore AJ, et al.‘Fast track’postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery[J]. Br J Surg, 2001, 88(11)：1533-1538.

1. 朱文俊 ,熊奇如 .恶性梗阻性黄疸的外科诊疗现状[ J].肝胆外科杂志 , 2010, 18(2)：154-156.
2. 张声定 . 梗阻性黄疸 120例临床分析[ J]. 中国现代医生 , 2010, 48(2)：107-108.
3. 刘祖军,赫军,伍松合,等.老年梗阻性黄疸 47例临床分析[ J]. 右江医学 , 2003, 31(4)：342-343.
4. 缪林, 刘政, 黄光明, 等. 老年梗阻性黄疸 30例诊治体会[ J].实用老年医学 , 2001, 15(6)：327-328.
5. 陈军周 ,周宁新 ,刘全达 ,等 .达芬奇机器人手术系统再手术入路的选择[ J]. 中华消化外科杂志 , 2010, 9(2)：105-108.
6. 王宁华. 疼痛定量评定的进展[J]. 中国临床康复 , 2002, 6(18)：2738-2739.
7. Kaasa T, Wesssl J. The Edmonton Functional Assessment Tool： further development and validation for use in palliative care[J]. J Palliative Care, 2001, 17：5-11.
8. Andereggen E, Ris F, Gervaz P，et al. Outcome of surgery for rectal cancer in octogenarians[J]. Swiss Med Wkly, 2006, 136(11-12)：185-188.
9. Etzioni DA, Liu JH, Maggard MA，et al. The aging population and its impact on the surgery workforce[J]. Ann Surg, 2003, 238(2)：170-177.
10. 陈宝公，刘家治 ,郝明利 ,等 .老年外科的有关问题[J].普外临床 , 1994, 2(2)：90-92.
11. Janssen-Heijnen ML, Maas HA, Houterman S, et al. Comorbidity in older surgical cancer patients：influence on patient care and outcome[J]. Eur J Cancer，2007, 43(15)：2179-2193.
12. Janssen-Heijnen ML, Houterman S, Lemmens VE，et al. Prognostic impact of increasing age and co-morbidity in cancer patients：a population-based approach[J]. Crit Rev Oncol Hematol, 2005, 55(3)：231-240.
13. Perseus J, Cornelius A，Meier J, et al. Tumor-induced occlusive jaundice-strategy of interventional drainage techniques[J]. Rontgenpraxis, 1995, 48(6)：170-174.
14. 廖文张 . 92例老年人胆道感染的急诊诊治[J]. 医学临床研究 , 2007, 24(11)：1962-1963.
15. 曲永利 .手术治疗老年急性重症胆管炎体会[J].实用医药杂志, 2008, 25(8)：936-937.
16. 吴在德 ,吴肇汉 .外科学[M] .北京：人民卫生出版社 , 2003： 581.
17. 周宁新，万涛 . 肝胆管结石病的外科治疗决策[J]. 中国实用外科杂志 , 2004, 24(2)：69-70.
18. Rosen M, Ponsky J. Minimally invasive surgery[J].Endoscopy, 2001, 33(4)：358-366.
19. Akiyoshi T, Kuroyanagi H, Oya M, et al. Short-term outcomes of laparoscopic rectal surgery for primary rectal cancer in elderly patients：is it safe and beneficial?[J]. J Gastrointest Surg, 2009, 13(9)：1614-1618.
20. 杜祥民 , 张永寿 . 达芬奇手术机器人系统介绍及应用进展[J] . 中国医学装备 , 2011, 8(5)：60-63.
21. Vignali A, Di Palo S, Tamburini A, et al. Laparoscopic vs. open colectomies in octogenarians：a case-matched control study[J]. Dis Colon Rectum, 2005, 48(11)：2070-2075.
22. Chautard J, Alves A, Zalinski S, et al. Laparoscopic colorectal surgery in elderly patients：a matched case-control study in 178 patients[J]. J Am Coll Surg, 2008, 206(2)：255-260.
23. Senagore AJ, Madbouly KM, Fazio VW, et al. Advantages of laparoscopic colectomy in older patients[J]. Arch Surg, 2003, 138(3)：252-256.
24. Cheung HY, Chung CC, Fung JT, et al. Laparoscopic resection for colorectal cancer in octogenarians：results in a decade[J]. Dis Colon Rectum, 2007, 50(11)：1905-1910.
25. Ceulemans R, Al-Ahdab N, Leroy J, et al. Safe laparoscopic surgery in the elderly[J]. Am J Surg, 2004, 187(3)：323-327.
26. Nguyen KT, Gamblin TC, Geller DA. World review of laparoscopic liver resection－2 804 patients[J]. Ann Surg, 2009, 250(5)：831-841.
27. Gagner M, Palermo M. Laparoscopic Whipple procedure：review of the literature[J]. J Hepatobiliary Pancreat Surg, 2009, 16(6)： 726-730.
28. 周宁新 .达芬奇机器人手术系统带给我们的挑战与启迪[J] .中华消化外科杂志 , 2010, 9(2)：90-92.
29. Gagner M, Pomp A. Laparoscopic pylorus-preserving pancreatoduodenectomy[J]. Surg Endosc, 1994, 8(5)：408-410.
30. Kendrick ML, Cusati D. Total laparoscopic pancreaticoduodenectomy：feasibility and outcome in an early experience[J]. Arch Surg, 2010, 145(1)：19-23.
31. 郑民华 .腹腔镜在胰十二指肠切除术中的应用与评价[J].中国微创外科杂志 , 2006, 6(1)：5-7.
32. Urbach DR, Swanstrom LL, Hansen PD. The effect of laparoscopy on survival in pancreatic cancer[J]. Arch Surg, 2002, 137(2)： 191-199.
33. Milone L, Turner P, Gagner M. Laparoscopic surgery for pancreatic tumors, an uptake[J]. Minerva Chir, 2004, 59(2)：165-173.
34. Palanivelu C, Jani K, Senthilnathan P, et al. Laparoscopic pancreaticoduodenectomy：technique and outcomes[J]. J Am Coll Surg, 2007, 205(2)：222-230.
35. Palanivelu C, Rajan PS, Rangarajan M, et al. Evolution in techniques of laparoscopic pancreaticoduodenectomy：a decade long experience from a tertiary center[J]. J Hepatobiliary Pancreat Surg, 2009, 16(6)：731-740.
36. Dulucq JL, Wintringer P, Mahajna A. Laparoscopic pancreaticoduodenectomy for benign and malignant diseases[J]. Surg Endosc, 2006, 20(7)：1045-1050.
37. Pugliese R, Scandroglio I, Sansonna F, et al. Laparoscopic pancreaticoduodenectomy：a retrospective review of 19 cases[J]. Surg Laparosc Endosc Percutan Tech, 2008, 18(1)：13-18.
38. Gagner M, Pomp A. Laparoscopic pancreatic resection：Is it worthwhile?[J]. J Gastrointest Surg, 1997, 1(1)：20-25.
39. Giulianotti PC, Coratti A, Angelini M, et al. Robotics in general surgery：personal experience in a large community hospital[J]. Arch Surg, 2003, 138(7)：777-784.
40. Nicolas B, Pietro A, Francesco B, et al．Safety of robotic general surgery in elderly patients[J]. J Robotic Surg, 2010, 4(2)：9198.
41. Buchs NC, Addeo P, Bianco FM, et al. Outcomes of robot-assisted pancreaticoduodenectomy in patients older than 70 years： a comparative study[J]. World J Surg, 2010, 34(9)：2109-2114.
42. Krohn BG，Kay JH, Mendez MA, et al. Rapid sustained recovery after cardiac operations[J]. Thorac Cardiovasc Surg, 1990, 100(2)：194-197.
43. Delaney CP, Fazio VW, Senagore AJ, et al.‘Fast track’postoperative management protocol for patients with high co-morbidity undergoing complex abdominal and pelvic colorectal surgery[J]. Br J Surg, 2001, 88(11)：1533-1538.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Application of da Vinci Surgical System in Senile Patients with Severe Obstructive Jaundice

Abstract Full text Figures/Tables Video References Cited by

Format

Content