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Multicenter Study
. 2023 Apr 1;277(4):e864-e871.
doi: 10.1097/SLA.0000000000005160. Epub 2021 Aug 19.

Perioperative and Oncological Outcomes of Robotic Versus Open Pancreaticoduodenectomy in Low-Risk Surgical Candidates: A Multicenter Propensity Score-Matched Study

Qu Liu  1 , Zhiming Zhao  1 , Xiuping Zhang  1 , Wei Wang  2 , Bing Han  3 , Xiong Chen  4 , Xiaodong Tan  5 , Shuai Xu  1 , Guodong Zhao  1 , Yuanxing Gao  1 , Qin Gan  1   6 , Jianlei Yuan  7 , Yuntao Ma  8 , Ye Dong  9 , Zhonghua Liu  10 , Hailong Wang  11 , Fangyong Fan  12 , Jianing Liu  13 , Wan Yee Lau  14 , Rong Liu  1
Affiliations
Multicenter Study

Perioperative and Oncological Outcomes of Robotic Versus Open Pancreaticoduodenectomy in Low-Risk Surgical Candidates: A Multicenter Propensity Score-Matched Study

Qu Liu et al. Ann Surg. .

Abstract

Objectives: This study aimed to perform a multicenter comparison between robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD).

Background: Previous comparisons of RPD versus OPD have only been carried out in small, single-center studies of variable quality.

Methods: Consecutive patients who underwent RPD (n = 1032) or OPD (n = 1154) at 7 centers in China between July 2012 and July 2020 were included. A 1:1 propensity score matching (PSM) was performed.

Results: After PSM, 982 patients in each group were enrolled. The RPD group had significantly lower estimated blood loss (EBL) (190.0 vs 260.0 mL; P < 0.001), and a shorter postoperative 1length of hospital stay (LOS) (12.0 (9.0-16.0) days vs 14.5 (11.0-19.0) days; P < 0.001) than the OPD group. There were no significant differences in operative time, major morbidity including clinically relevant postoperative pancreatic fistula (CR-POPF), bile leakage, delayed gastric emptying, postoperative pancreatectomy hemorrhage (PPH), reoperation, readmission or 90-day mortality rates. Multivariable analysis showed R0 resection, CR-POPF, PPH and reoperation to be independent risk factors for 90-day mortality. Subgroup analysis on patients with pancreatic ductal adenocarcinoma (PDAC) (n = 326 in each subgroup) showed RPD had advantages over OPD in EBL and postoperative LOS. There were no significant differences in median disease-free survival (15.2 vs 14.3 months, P = 0.94) or median overall survival (24.2 vs 24.1 months, P = 0.88) between the 2 subgroups.

Conclusions: RPD was comparable to OPD in feasibility and safety. For patients with PDAC, RPD resulted in similar oncologic and survival outcomes as OPD.

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Conflict of interest statement

The authors report no conflicts of interest.

Comment in

References

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