Evidence map›Paper›PMID 38844730›Full record

ArticleSurgical endoscopy2024

Minimally invasive total pancreatectomy with islet autotransplantation for chronic pancreatitis: the robotic approach.

Benedict Kinny-Köster, Christi M Walsh, Zhaoli Sun, Mahya Faghih, Niraj M Desai, Daniel S Warren, Rita R Kalyani, Courtney Roberts, Vikesh K Singh, Martin A Makary and 1 more

Abstract read
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In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Benedict Kinny-KösterDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Christi M WalshDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Zhaoli SunDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Mahya FaghihDivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Niraj M DesaiDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Daniel S WarrenDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Rita R KalyaniDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Courtney RobertsDivision of Endocrinology, Diabetes, and Metabolism, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Vikesh K SinghDivision of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Martin A MakaryDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA.
Jin HeDivision of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Blalock 665, Baltimore, MD, 21287, USA. jhe11@jhmi.edu.ORCID 0000-0001-9149-2247

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTotal pancreatectomy with islet autotransplantation (TPIAT) treats refractory pain in chronic pancreatitis, prevents episodes of acute exacerbation, and mitigates postoperative brittle diabetes. The minimally invasive (MIS) approach offers a decreased surgical access trauma and enhanced recovery. Having established a laparoscopic TPIAT program, we adopted a robotic approach (R-TPIAT) and studied patient outcomes compared to open TPIAT.

methodsBetween 2013 and 2021, 61 adult patients underwent TPIAT after a comprehensive evaluation (97% chronic pancreatitis). Pancreatic islets were isolated on-site during the procedure. We analyzed and compared intraoperative surgical and islet characteristics, postoperative morbidity and mortality, and 1-year glycemic outcomes.

resultsMIS-TPIAT was performed in 41 patients (67%, 15 robotic and 26 laparoscopic), and was associated with a shorter mean length of intensive care unit stay compared to open TPIAT (2.9 vs 4.5 days, p = 0.002). R-TPIAT replaced laparoscopic TPIAT in 2017 as the MIS approach of choice and demonstrated decreased blood loss compared to open TPIAT (324 vs 843 mL, p = 0.004), similar operative time (609 vs 562 min), 30-day readmission rate (7% vs 15%), and 90-day complication rate (13% vs 20%). The glycemic outcomes including C-peptide detection at 1-year (73% vs 88%) and insulin dependence at 1-year (75% vs 92%) did not differ. The mean length of hospital stay after R-TPIAT was 8.6 days, shorter than for laparoscopic (11.5 days, p = 0.031) and open TPIAT (12.6 days, p = 0.017). Both MIS approaches had a 1-year mortality rate of 0%.

conclusionsR-TPIAT was associated with a 33% reduction in length of hospital stay (4-day benefit) compared to open TPIAT. R-TPIAT was similar to open TPIAT on measures of feasibility, safety, pain control, and 1-year glycemic outcomes. Our data suggest that robotic technology, a new component in the multidisciplinary therapy of TPIAT, is poised to develop into the primary surgical approach for experienced pancreatic surgeons.

Indexed as

Islets of Langerhans TransplantationPancreatectomyPancreatitis, ChronicRobotic Surgical ProceduresTransplantation, AutologousAdultFemaleHumansLaparoscopyLength of StayMaleMiddle AgedMinimally Invasive Surgical ProceduresOperative TimePostoperative ComplicationsRetrospective StudiesHereditary pancreatitisIslet cell autotransplantationIslet transplantationPancreatic surgeryRobotic pancreatectomyRobotic surgery

Identifiers

PMID38844730

What Socratic holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.