Robot-assisted Partington-Rochelle procedure for chronic pancreatitis: a technical note with video presentation

Abstract

Chronic pancreatitis (CP) is a progressive inflammatory disease characterized by debilitating pain and exocrine insufficiency. When medical and endoscopic treatments fail, surgical decompression may be required. The Partington-Rochelle procedure, a well-established option for ductal decompression via pancreaticojejunostomy, is traditionally performed through open surgery. While the laparoscopic approach is technically challenging, robotic-assisted surgery offers enhanced precision, reduced trauma, and faster recovery. We present the case of a 45-year-old male with CP, recurrent pseudocyst formation, and persistent symptoms despite medical and endoscopic treatment. The patient underwent a robotic Partington-Rochelle procedure using the Da Vinci Xi system. The procedure was successfully completed in 240 min with and an estimated blood loss of 150 mL. Postoperative recovery was uneventful, and the patient was discharged on postoperative day 7 with no complications. At the 3-month follow-up, symptoms had completely resolved, and cyst size had decreased. At 30 months, the patient remained asymptomatic and no longer required analgesics. MRI showed stable pancreatic parenchyma with reduced cystic lesions, and fecal elastase levels indicated mild pancreatic insufficiency. This case highlights the feasibility and effectiveness of the robotic Partington-Rochelle procedure for CP management. The robotic approach provides superior visualization and precision, enabling optimal ductal decompression while overcoming the limitations of laparoscopic and open techniques. Compared to traditional open surgery, it offers faster recovery, reduced morbidity, and excellent long-term symptom control, making it a promising alternative for selected patients.

Keywords

Robot-assisted surgery / Partington-Rochelle procedure / chronic pancreatitis / minimally invasive surgery

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