Fully robotic central pancreatectomy with pancreaticogastrostomy using a double-J pancreatic duct stent: a video vignette

초록

Background Central pancreatectomy is a parenchyma-sparing procedure indicated for benign or low-grade malignant lesions located in the pancreatic neck or proximal body. Despite its functional advantages, postoperative pancreatic fistula (POPF) remains the most common complication because pancreatic reconstruction is required. Although internal pancreatic duct stents are commonly used, conventional straight stents may be limited by terminal obstruction or restricted drainage outlets. A tailored double-J ureteral stent segment may provide an alternative internal drainage configuration during pancreaticogastrostomy.Methods We present a video vignette of a patient who underwent fully robotic central pancreatectomy with pancreaticogastrostomy using a tailored internal double-J pancreatic duct stent. A literature review was performed to summarize previously reported minimally invasive central pancreatectomy series and reconstruction strategies involving internal pancreatic duct drainage.Results The procedure was completed robotically without intraoperative complications. The operative time was 357 min with an estimated blood loss of 200 mL. The patient resumed oral intake on postoperative day (POD) 2 and a soft diet on POD 3. Drain amylase levels on POD 5 did not meet criteria for POPF, and the drain was removed on POD 6. The patient was discharged on POD 7 without postoperative complications. At 3-month follow-up, CT demonstrated no evidence of recurrence or procedure-related complications, and the internal stent was no longer visible.Conclusion Fully robotic central pancreatectomy with pancreaticogastrostomy using a tailored double-J ureteral stent segment was technically feasible. This video vignette highlights the key operative steps of this reconstruction technique and may serve as a useful technical reference for robotic pancreaticogastrostomy after central pancreatectomy. Further studies are required to evaluate its clinical utility and impact on postoperative outcomes.

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