Background: Postoperative pancreatic fistula (POPF) is a significant contributor to morbidity and mortality after robotic distal pancreatectomy (RDP). Ligamentum teres hepatis (LTH) reinforcement of the pancreatic remnant may reduce the incidence of POPF.
Methods: Patients ≥18 years old, who underwent RDP at the University of Massachusetts Memorial Medical Center from 01/01/2018-08/31/2022. Primary endpoint was POPF incidence. Secondary outcomes included peri- and postoperative variables.
Results: Thirty-three patients underwent RDP, of which LTH reinforcement was used in 21 (64 %) cases. Six (18 %) patients developed a POPF. No association was identified between LTH flap reinforcement and POPF (OR 1.18, 95 % CI 0.18 to 7.85, p = 0.87). There were no peri- or postoperative complications related to ligamentum teres flap creation.
Conclusions: LTH reinforcement of the pancreatic remnant can be safely performed during RDP. Further studies are needed to assess the utility of this intervention to mitigate the risk of pancreatic fistula formation following RDP.
Keywords: Falciform flap; Ligamentum teres hepatis flap; Pancreas surgery; Pancreatic leak; Robotic surgery.
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