ArticleSurgical endoscopy2025
Pancreatic head clockwise devascularization technique during robotic pancreaticoduodenectomy to minimize intraoperative bleeding.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Evaluating the value of robotic versus open pancreaticoduodenectomy: improved clinical outcomes without compromising hospital revenue per admission.Surgery today · 2026Review
- Robotic pancreaticoduodenectomy: a structured narrative review of learning curve, patient selection, and program readiness.Journal of robotic surgery · 2026Review
- Super-resolution deep learning reconstruction improves the depiction of peripancreatic arteries and image quality in pancreatic cancer CT.Abdominal radiology (New York) · 2026Article
- Quadruple reinforcement technique for pancreatic stump during robotic distal pancreatectomy.Surgical endoscopy · 2026Article
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Authors and funding
9 authors.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreaticoduodenectomy (PD) is a complex procedure, and robotic PD (RPD) has been reported to have benefits in reducing postoperative complications. However, the timing and order for dividing arteries and veins remain unstandardized. We developed a novel technique, pancreatic head clockwise devascularization, to minimize intraoperative bleeding in RPD.
methodsWe retrospectively analyzed 39 patients who underwent RPD between April 2022 and September 2024. The clockwise devascularization technique divides 1) the gastroduodenal artery, 2) the 1st-jejunal vein branches, and 3) the inferior pancreatoduodenal artery + 1st-jejunal artery. Outcomes were compared with the conventional superior mesenteric artery (SMA)-first approach.
resultsOf the 39 patients, 14 were in the clockwise devascularization group and 25 in the SMA-first group. The clockwise group had a significantly shorter operation time (616 vs. 772 min, P < 0.01) and lower blood loss (50 vs. 330 ml, P = 0.03). There were no clinically relevant pancreatic fistulas or delayed gastric emptying in either group. The median hospital stay was shorter in the clockwise group (5.5 vs. 8.0 days, P < 0.01).
conclusionsThe pancreatic head clockwise devascularization technique may be an effective technique to systematically devascularize the pancreatic head.
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