Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May;24(5):1111-1118.
doi: 10.1007/s11605-019-04274-1. Epub 2019 Jul 2.

Robotic Pancreaticoduodenectomy Is Associated with Decreased Clinically Relevant Pancreatic Fistulas: a Propensity-Matched Analysis

Jianpeng Cai #  1 , Rajesh Ramanathan #  2 , Mazen S Zenati  3 , Amr Al Abbas  2 , Melissa E Hogg  4 , Herbert J Zeh  5 , Amer H Zureikat  6
Affiliations

Robotic Pancreaticoduodenectomy Is Associated with Decreased Clinically Relevant Pancreatic Fistulas: a Propensity-Matched Analysis

Jianpeng Cai et al. J Gastrointest Surg. 2020 May.

Abstract

Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD) is a major complication that adversely affects recovery. The robotic approach may decrease the incidence of this complication. This propensity-matched analysis evaluates the impact of robotic PD (RPD) on CR-POPF.

Methods: Patients undergoing PD after the learning curve at a high-volume academic medical center were reviewed. CR-POPF outcomes after open PD (OPD) and RPD were compared. Logistic regression and propensity score matching (PSM) were used to define the independent effect of RPD on CR-POPF.

Results: Of 865 PDs performed over the study period, 405 (46.8%) were OPD and 460 (53.2%) were RPD. RPD was associated with a similar overall POPF rate, but a lower incidence of CR-POPF (6.7% vs. 15.8%, p < 0.001). On multivariate analysis, RPD was an independent predictor of lower CR-POPF (OR 0.278, p < 0.001). Following propensity matching, RPD continued to be protective against the occurrence of CR-POPF (coefficient = - 0.113, p = 0.001).

Conclusions: This is the largest single-center PSM analysis to evaluate the impact of robotic approach on pancreatoduodenectomy and suggests that RPD can minimize the clinical impact of pancreatic leaks after PD.

Keywords: Minimally invasive; Pancreas fistula; Pancreatic leak; Pancreaticoduodenectomy; Whipple.

PubMed Disclaimer

References

    1. Nappo G, Perinel J, El Bechwaty M, Adham M. The Standardization of Pancreatoduodenectomy: Where Are We? Pancreas. 2016;45(4):493–502. doi: https://doi.org/10.1097/MPA.0000000000000503 - DOI - PubMed
    1. Pratt WB, Maithel SK, Vanounou T, Huang ZS, Callery MP, Vollmer CM. Clinical and economic validation of the International Study Group of Pancreatic Fistula (ISGPF) classification scheme. Ann Surg. 2007;245(3):443–451. doi: https://doi.org/10.1097/01.sla.0000251708.70219.d2 - DOI - PubMed - PMC
    1. Callery MP, Pratt WB, Kent TS, Chaikof EL, Vollmer CM. A prospectively validated clinical risk score accurately predicts pancreatic fistula after pancreatoduodenectomy. J Am Coll Surg. 2013;216(1):1–14. doi: https://doi.org/10.1016/j.jamcollsurg.2012.09.002 - DOI - PubMed
    1. Hu B-Y, Wan T, Zhang W-Z, Dong J-H. Risk factors for postoperative pancreatic fistula: Analysis of 539 successive cases of pancreaticoduodenectomy. World J Gastroenterol. 2016;22(34):7797–7805. doi: https://doi.org/10.3748/wjg.v22.i34.7797 - DOI - PubMed - PMC
    1. Malleo G, Pulvirenti A, Marchegiani G, Butturini G, Salvia R, Bassi C. Diagnosis and management of postoperative pancreatic fistula. Langenbecks Arch Surg. 2014;399(7):801–810. doi: https://doi.org/10.1007/s00423-014-1242-2 - DOI - PubMed

MeSH terms

LinkOut - more resources