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Perioperative Outcomes of Robotic Pancreaticoduodenectomy: a Propensity-Matched Analysis to Open and Laparoscopic Pancreaticoduodenectomy

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Introduction

Robotic pancreaticoduodenectomy is slowly gaining acceptance within pancreatic surgery. Advantages have been demonstrated for robotic surgery in other fields, but robust data for pancreaticoduodenectomy is limited. The aim of this study was to compare the short-term outcomes of robotic pancreaticoduodenectomy (RPD) to open pancreaticoduodenectomy (OPD) and laparoscopic pancreaticoduodenectomy (LPD).

Methods

Patients who underwent a pancreaticoduodenectomy between January 2011 and July 2019 at the Johns Hopkins Hospital were included in this retrospective propensity-matched analysis. The RPD cohort was matched to patients who underwent OPD in a 1:2 fashion and LPD in a 1:1 fashion. Short-term outcomes were analyzed for all three cohorts.

Results

In total, 1644 patients were included, of which 96 (5.8%) underwent RPD, 131 (8.0%) LPD, and 1417 (86.2%) OPD. RPD was associated with a decreased incidence of delayed gastric emptying (9.4%) compared to OPD (23.5%; P = 0.006). The median estimated blood loss was significantly less in the RPD cohort (RPD vs OPD, 150 vs 487 mL; P < 0.001, RPD vs LPD, 125 vs 300 mL; P < 0.001). Compared to OPD, the robotic approach was associated with a shorter median length of stay (median 8 vs 9 days; P = 0.014) and a decrease in wound complications (4.2% vs 16.7%; P = 0.002). The incidence of other postoperative complications was comparable between RPD and OPD, and RPD and LPD.

Conclusion

In the hands of experienced surgeons, RPD may have a modest yet statistically significant reduction in estimated blood loss, postoperative length of stay, wound complications, and delayed gastric emptying comparing to OPD in similar patients.

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Author notes

  1. A. Floortje van Oosten and Ding Ding contributed equally to this work.

Authors and Affiliations

  1. Department of Surgery, The Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Halsted 614, Baltimore, MD, 21287, USA

    A. Floortje van Oosten, Ding Ding, Joseph R. Habib, Ahmer Irfan, Ryan K. Schmocker, Elisabetta Sereni, Benedict Kinny-Köster, Michael Wright, Vincent P. Groot, I. Quintus Molenaar, John L. Cameron, Martin Makary, Richard A. Burkhart, William R. Burns, Christopher L. Wolfgang & Jin He

  2. Department of Surgery, UMC Utrecht Cancer Center, University Medical Center Utrecht, Utrecht, The Netherlands

    A. Floortje van Oosten, Vincent P. Groot & I. Quintus Molenaar

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  1. A. Floortje van Oosten
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  2. Ding Ding
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Contributions

AF van Oosten; D Ding; J He: project development, data analysis and collection, manuscript writing

J Habib; A Irfan; R Schmocker; E Sereni; B Kinny-Köster; M Wright; V Groot; I. Molenaar: data collection, manuscript editing

J Cameron; M Makary; R Burkhart; W Burns; C Wolfgang: data collection, manuscript editing

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Correspondence to Jin He.

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van Oosten, A.F., Ding, D., Habib, J.R. et al. Perioperative Outcomes of Robotic Pancreaticoduodenectomy: a Propensity-Matched Analysis to Open and Laparoscopic Pancreaticoduodenectomy. J Gastrointest Surg 25, 1795–1804 (2021). https://doi.org/10.1007/s11605-020-04869-z

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