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. 2018 Oct;7(5):345-352.
doi: 10.21037/hbsn.2018.09.03.

Which method of distal pancreatectomy is cost-effective among open, laparoscopic, or robotic surgery?

Maylis Rodriguez  1 , Riccardo Memeo  1   2   3 , Piera Leon  4 , Fabrizio Panaro  4 , Stylianos Tzedakis  1 , Ornella Perotto  1 , Sharmini Varatharajah  1 , Nicola de'Angelis  1 , Pietro Riva  1 , Didier Mutter  1   2   3 , Francis Navarro  4 , Jacques Marescaux  2   3 , Patrick Pessaux  1   2   3
Affiliations

Which method of distal pancreatectomy is cost-effective among open, laparoscopic, or robotic surgery?

Maylis Rodriguez et al. Hepatobiliary Surg Nutr. 2018 Oct.

Abstract

Background: The aim of this study was to analyze the clinical and economic impact of robotic distal pancreatectomy, laparoscopic distal pancreatectomy, and open distal pancreatectomy.

Methods: All consecutive patients who underwent distal pancreatic resection for benign and malignant diseases between January 2012 and December 2015 were prospectively included. Cost analysis was performed; all charges from patient admission to discharge were considered.

Results: There were 21 robotic (RDP), 25 laparoscopic (LDP), and 43 open (ODP) procedures. Operative time was longer in the RDP group (RDP =345 minutes, LDP =306 min, ODP =251 min, P=0.01). Blood loss was higher in the ODP group (RDP =192 mL, LDP =356 mL, ODP =573 mL, P=0.0002). Spleen preservation was more frequent in the RDP group (RDP =66.6%, LDP =61.9%, ODP =9.3%, P=0.001). The rate of patients with Clavien-Dindo > grade III was higher in the ODP group (RDP =0%, LDP =12%, ODP =23%, P=0.01), especially for non-surgical complications, which were more frequent in the ODP group (RDP =9.5%, LDP =24%, ODP =41.8%, P=0.02). Length of hospital stay was increased in the ODP group (ODP =19 days, LDP =13 days, RDP =11 days, P=0.007). The total cost of the procedure, including the surgical procedure and postoperative course was higher in the ODP group (ODP =30,929 Euros, LDP =22,150 Euros, RDP =21,219 Euros, P=0.02).

Conclusions: Cost-effective results of RDP seem to be similar to LDP with some better short-term outcomes.

Keywords: Robotic; cost-effective; distal pancreatectomy; laparoscopic.

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Conflict of interest statement

Conflicts of Interest: The authors have no conflicts of interest to declare.

Comment in

References

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