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A comparative analysis of robotic versus open pancreaticoduodenectomy in octogenarians

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Abstract

Old age is a predictor of increased morbidity following pancreatic operations. This study was undertaken to compare the peri-operative variables between robotic and ‘open’ pancreaticoduodenectomy, in octogenarians (≥ 80 years of age). Since 2012, with IRB approval, we retrospectively followed 69 patients, who underwent robotic (n = 42) and ‘open’ (n = 27) pancreaticoduodenectomy. Statistical analysis was performed using chi-square test and Student’s t test. Data are presented as median(mean ± SD), and significance accepted with 95% probability. Patients who underwent the robotic approach had a greater Charlson Comorbidity Index [6 (6 ± 1.6) vs 5 (5 ± 1.0), (p = 0.01)] and previous abdominal operations [n = 24 (57%) vs n = 9 (33%), (p = 0.04)]. The robotic approach led to longer operative time [426 (434 ± 95.8) vs 240 (254 ± 71.1) minutes, (p < 0.0001)], decreased blood loss [200 (291 ± 289.2) vs 426 (434 ± 95.8) mL (p = 0.008)], and decreased intraoperative blood transfusions (p < 0.05). Patients who underwent robotic pancreaticoduodenectomy had comparable and at times superior outcomes, consistent with the literature regarding robotic and ‘open’ pancreaticoduodenectomy. This study indicates that robotic pancreaticoduodenectomy continues to offer same benefits for patients of advanced age and demonstrates age should not be a preclusion to robotic operations.

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Data availability

Due to the sensitive nature of the research data and the privacy constraints imposed by our study protocol, the data that support the findings of this study are not publicly available. All relevant data are protected to ensure participant confidentiality and comply with ethical standards.

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This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Digestive Health Institute, AdventHealth, 3000 Medical Park Drive, Suite #500, Tampa, FL, 33613, USA

    Sharona Ross, Iswanto Sucandy, Maria Christodoulou, Tara Pattilachan & Alexander Rosemurgy

  2. University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Padma Vasanthakumar

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  1. Sharona Ross
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Contributions

Conceptualization: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Methodology: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Formal analysis and investigation: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Writing—original draft preparation: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Writing—review and editing: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Resources: S.B.R., I.S., P.V., M.C., T.M.P., A.R.; Supervision: S.B.R., I.S., P.V., M.C., T.M.P., A.R.

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Correspondence to Sharona Ross.

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Conflict of interest

Padma Vasanthakumar, Maria Christodoulou, Tara M. Pattilachan, Iswanto Sucandy, and Alexander Rosemurgy have no conflicts of interest or financial ties to disclose. Dr. Sharona B. Ross is a consultant for Intuitive Surgical (Sunnyvale, CA) and Ethicon (Cincinnati, OH). Dr. Sharona B. Ross receives educational grants for the Women in Surgery Career Symposium from Intuitive Surgical and Medtronic (Minneapolis, MN).

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Ross, S., Sucandy, I., Vasanthakumar, P. et al. A comparative analysis of robotic versus open pancreaticoduodenectomy in octogenarians. J Robotic Surg 18, 183 (2024). https://doi.org/10.1007/s11701-024-01952-4

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