Wei ZG, Liang CJ, Du Y, Zhang YP, Liu Y. Learning curve for a surgeon in robotic pancreaticoduodenectomy through a “G”-shaped approach: A cumulative sum analysis. World J Clin Cases 2022; 10(14): 4357-4367 [PMID: 35663072 DOI: 10.12998/wjcc.v10.i14.4357]
Corresponding Author of This Article
Zhi-Gang Wei, MD, Surgeon, Surgical Oncologist, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, No. 85 Jiefangnan Road, Yingze Strict, Taiyuan 030001, Shanxi Province, China. sdyywzg2018@126.com
Research Domain of This Article
Surgery
Article-Type of This Article
Clinical and Translational Research
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. May 16, 2022; 10(14): 4357-4367 Published online May 16, 2022. doi: 10.12998/wjcc.v10.i14.4357
Learning curve for a surgeon in robotic pancreaticoduodenectomy through a “G”-shaped approach: A cumulative sum analysis
Zhi-Gang Wei, Chao-Jie Liang, Yang Du, Yong-Ping Zhang, Yu Liu
Zhi-Gang Wei, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Chao-Jie Liang, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Yang Du, Operating Room, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Yong-Ping Zhang, Yu Liu, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital/First Clinical Medical College of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China
Author contributions: Wei ZG designed the research study; Liang CJ and Zhang YP performed the research; Wei ZG and Zhang YP analyzed the data and wrote the manuscript; Du Y drew the image; and all authors have read and approved the final manuscript.
Supported byShanxi Provincial Science and Technology Department Social Development Fund, No. 201903D321144.
Institutional review board statement: The study was reviewed and approved by the First Hospital of Shanxi Medical University Institutional Review Board (Approval No. 2019SK13).
Clinical trial registration statement: This study is registered at Chinese Clinical Trial Registry. The registration identification number is ChiCTR210053744.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Zhi-Gang Wei, MD, Surgeon, Surgical Oncologist, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Shanxi Medical University, No. 85 Jiefangnan Road, Yingze Strict, Taiyuan 030001, Shanxi Province, China. sdyywzg2018@126.com
Received: February 22, 2021 Peer-review started: February 22, 2021 First decision: September 28, 2021 Revised: October 19, 2021 Accepted: March 24, 2022 Article in press: March 24, 2022 Published online: May 16, 2022 Processing time: 444 Days and 21.9 Hours
Abstract
BACKGROUND
Robotic pancreaticoduodenectomy (RPD) can achieve similar surgical results to open and PD; however, RPD has a long learning curve and operation time (OT). To address this issue, we have summarized a surgical path to shorten the surgical learning curve and OT.
AIM
To investigate the effective learning curve of a “G”-shaped surgical approach in RPD for patients.
METHODS
A total of 60 patients, who received “G”-shaped RPD (GRPD) by a single surgeon in the First Hospital of Shanxi Medical University from May 2017 to April 2020, were included in this study. The OT, demographic data, intraoperative blood loss, complications, hospitalization time, and pathological results were recorded, and the cumulative sum (CUSUM) analysis was performed to evaluate the learning curve for GRPD.
RESULTS
According to the CUSUM analysis, the learning curve for GRPD was grouped into two phases: The early and late phases. The OT was 480 ± 81.65 min vs 331 ± 76.54 min, hospitalization time was 22 ± 4.53 d vs 17 ± 6.08 d, and blood loss was 308 ± 54.78 mL vs 169.2 ± 35.33 mL in the respective groups. Complications, including pancreatic fistula, bile leakage, reoperation rate, postoperative death, and delayed gastric emptying, were significantly decreased after this surgical technique.
CONCLUSION
GRPD can improve the learning curve and operative time, providing a new method for shortening the RPD learning curve.
Core Tip: Robotic pancreaticoduodenectomy (RPD) can achieve similar surgical results to open and PD; however, RPD has a long learning curve and operation time. A total of 60 patients, who received “G”-shaped RPD (GRPD) by a single surgeon in the First Hospital of Shanxi Medical University from May 2017 to April 2020, were included in this study. GRPD can improve the learning curve and operative time, providing a new method for shortening the RPD learning curve.
