探讨机器人胰十二指肠切除术治疗儿童胰胆系恶性肿瘤的可行性、安全性、疗效和初步经验。

回顾性分析2023年4月至2024年2月广州医科大学附属妇女儿童医疗中心收治的3例胰胆系恶性肿瘤接受机器人胰十二指肠切除术的临床资料，男1例，女2例，手术方式为达芬奇机器人保留幽门的胰十二指肠切除术，术后随访12~18个月。

3例患者分别为29个月、12岁和23个月，病例1肿瘤位于壶腹部，侵犯胰头及胆总管，大小为31 mm×27 mm×25 mm，病例2、3肿瘤位于胰头，大小分别为110 mm×98 mm×90 mm、69 mm×58 mm×45 mm，均行机器人保留幽门的胰十二指肠切除术，术后病理检查结果例1、2、3分别为壶腹部横纹肌肉瘤、实性假乳头状瘤、胰母细胞瘤。3例均痊愈出院，病例1围术期出现胃排空障碍，保守治疗1周后痊愈。随访期间，3例均恢复良好，无术中及术后大出血、胰漏、胆漏、胃肠吻合口漏、吻合口狭窄、肠梗阻、急性胰腺炎、肿瘤复发等并发症，生长发育良好。

机器人胰十二指肠切除术用于儿童胰胆系恶性肿瘤安全、可行，短期和中期效果良好。

To explore the feasibility, safety, efficacy, and preliminary experience of robotic pancreatoduodenectomy (RPD) in the treatment of pediatric malignant pancreaticobiliary tumors.

A retrospective analysis was performed on the clinical data of 3 children with malignant pancreaticobiliary tumors who underwent RPD at Guangzhou Medical University Affiliated Women and Children's Medical Center from Apr. 2023 to Feb. 2024. The patients were 1 male and 2 female. The surgical procedure was robotic pylorus-preserving pancreatoduodenectomy (RPPPD) using the da Vinci robotic system Xi. Postoperative follow-up was conducted for 12 to 18 months.

The 3 patients were aged 29 months, 12 years, and 23 months, respectively. Case 1 had a tumor located in the ampulla of vater, invading the pancreatic head and common bile duct, with a size of 31 mm×27 mm×25 mm. Case 2 and 3 had tumors located in the pancreatic head, with sizes of 110 mm×98 mm×90 mm and 69 mm×58 mm×45 mm, respectively. All three patients underwent RPPPD. Postoperative pathological examination results revealed ampullary rhabdomyosarcoma in patient 1, solid pseudopapillary neoplasm in patient 2, and pancreatoblastoma in patient 3. All patients were discharged from the hospital with complete recovery. Patient 1 experienced gastric emptying disorder during the perioperative period, which resolved after 1 week of conservative treatment. During the follow-up period, all patients recovered well without any intraoperative or postoperative complications such as major bleeding, pancreatic fistula, biliary fistula, gastrointestinal anastomotic leakage, anastomotic stricture, intestinal obstruction, acute pancreatitis, or tumor recurrence. The three children are growing and developing well.

Robotic pancreatoduodenectomy is safe and feasible for malignant pancreaticobiliary tumors in children, with good short-term and medium-term outcomes.