Surgical Endoscopy

, Volume 34, Issue 2, pp 501–509 | Cite as

Robotic versus open pancreaticoduodenectomy: a meta-analysis of short-term outcomes

  • Qing Yan
  • Lei-bo Xu
  • Ze-fang Ren
  • Chao LiuEmail author
Review Article



Although robotic surgery is popular around the world, its safety and efficacy over classical open surgery is still controversial. The purpose of this article is to compare the safety and efficacy of robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD).


A literature search of PubMed, Web of Science, and the Cochrane Library database up to July 29, 2018 was performed and the meta-analysis was performed using RevMan 5.2 software with Fixed and random effects models applied. The IRB approval and written consent were not needed for this paper.


Twelve non-randomized retrospective studies and 1 non-randomized prospective study consisting of 2403 patients were included in this meta-analysis. There were 788 (33%) patients in the RPD group and 1615 (67%) patients in the OPD group. Although RPD was associated with a longer operative time (weighted mean difference [WMD]: 71.74 min; 95% CI 23.37–120.12; p = 0.004), patient might benefit from less blood loss (WMD: − 374.03 ml; 95% CI − 506.84 to − 241.21; p < 0.00001), shorter length of stay (WMD: − 5.19 day; 95% CI − 8.42 to − 1.97; p = 0.002), and lower wound infection rate (odds ratio: 0.17; 95% CI 0.04–0.80; p = 0.02). No statistically significant difference was observed in positive margin rate, lymph nodes harvested, postoperative complications, reoperation or readmission rate, and mortality rate.


Robotic pancreaticoduodenectomy is a safe and feasible alternative to open pancreaticoduodenectomy with regard to short-term outcomes. Further studies on the long-term outcomes of these surgical techniques are needed.


Robot Open Pancreaticoduodenectomy Meta-analysis 



This work was supported by the Natural Science Foundation of China (81672412), the Natural Science Foundation of China (81772597), Science and Technology Program of Guangzhou, China (201607010111), the Guangdong Science and Technology Foundation (2017A020215196), the Guangdong Natural Science Foundation (2017A030311002), Pearl River S&T Nova Program of Guangzhou, China (201610010022), Fundamental Research Funds for the Central Universities of Sun Yat-sen University (17ykpy44), Grant [2013]163 from Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology, Grant KLB09001 from the Key Laboratory of Malignant Tumor Gene Regulation and Target Therapy of Guangdong Higher Education Institutes, and Grant from Guangdong Science and Technology Department (2015B050501004).

Compliance with ethical standards


Drs. Qing Yan, Lei-bo Xu, Ze-fang Ren, and Chao Liu have no conflicts of interest or financial ties to disclose.

Supplementary material

464_2019_7084_MOESM1_ESM.jpg (358 kb)
Supplementary Fig. 1. Forest plot showing the results of the meta-analysis regarding positive margin rate. Supplementary material 1 (JPEG 358 kb)
464_2019_7084_MOESM2_ESM.jpg (302 kb)
Supplementary Fig. 2. Forest plot showing the results of the meta-analysis regarding lymph nodes harvested. Supplementary material 2 (JPEG 302 kb)
464_2019_7084_MOESM3_ESM.jpg (297 kb)
Supplementary Fig. 3. Forest plot showing the results of the meta-analysis regarding Clavien–Dindo grade ≥ III Supplementary material 3 (JPEG 296 kb)
464_2019_7084_MOESM4_ESM.jpg (274 kb)
Supplementary Fig. 4. Forest plot showing the results of the meta-analysis regarding postoperative bleeding. Supplementary material 4 (JPEG 274 kb)
464_2019_7084_MOESM5_ESM.jpg (355 kb)
Supplementary Fig. 5. Forest plot showing the results of the meta-analysis regarding pancreatic fistula. Supplementary material 5 (JPEG 354 kb)
464_2019_7084_MOESM6_ESM.jpg (340 kb)
Supplementary Fig. 6. Forest plot showing the results of the meta-analysis regarding severe pancreatic fistula. Supplementary material 6 (JPEG 339 kb)
464_2019_7084_MOESM7_ESM.jpg (567 kb)
Supplementary Fig. 7. Forest plot showing the results of the meta-analysis regarding mortality. Supplementary material 7 (JPEG 566 kb)
464_2019_7084_MOESM8_ESM.jpg (586 kb)
Supplementary Fig. 8. Forest plot showing the results of the meta-analysis regarding reoperation or readmission. Supplementary material 8 (JPEG 586 kb)
464_2019_7084_MOESM9_ESM.doc (74 kb)
Supplementary material 9 (DOC 73 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina
  2. 2.Department of Biliary-Pancreatic Surgery, Sun Yat-sen Memorial HospitalSun Yat-sen UniversityGuangzhouChina
  3. 3.Department of Epidemiology & Statistics School of Public HealthSun Yat-sen UniversityGuangzhouChina

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