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Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery

Abstract

Background

An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy.

The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy.

Methods

Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014–2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications.

Results

We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55%) were performed laparoscopically and 193 (45%) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09), vascular resection (OR, 2.10; 95% CI, 1.23–3.58), and longer operative time (OR, 1.002; 95% CI, 1.001–1.004).

Conclusions

Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.

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Acknowledgements

Research reported in this publication was supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001105. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. They would like to thank Dave Primm for his help in editing this manuscript and Helen Mayo from the UT Southwestern Health Sciences Digital Library and Learning Center for assistance with literature searches. RMM is the Alvin Baldwin, Jr. Chair in surgery. MRP is the Dedman Family Scholar in clinical care. SCW is a UT Southwestern Disease-Oriented Clinical Scholar.

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA

    Ibrahim Nassour, Sam C. Wang, Matthew R. Porembka, Adam C. Yopp, Michael A. Choti, Mathew M. Augustine, Patricio M. Polanco, John C. Mansour & Rebecca M. Minter

  2. University of Texas Southwestern Medical Center, Simmons Comprehensive Cancer Center, Dallas, TX, 75390, USA

    Sam C. Wang, Matthew R. Porembka, Adam C. Yopp, Michael A. Choti, Mathew M. Augustine, Patricio M. Polanco, John C. Mansour & Rebecca M. Minter

  3. Division of Surgical Oncology, UT Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX, 75390-9031, USA

    Rebecca M. Minter

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  1. Ibrahim Nassour
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  2. Sam C. Wang
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  3. Matthew R. Porembka
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Contributions

I. Nassour and R. Minter: study design, data analysis and interpretation, writing initial draft, and revising and approving the final draft; S. Wang, P. Polanco, M. Augustine, J. Mansour, M. Porembka, A. Yopp, M. Choti: data interpretation and revising and approving the final draft.

Corresponding author

Correspondence to Rebecca M. Minter.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Source of Funding

The National Center for Advancing Translational Sciences of the National Institutes of Health under award number UL1TR001105.

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Nassour, I., Wang, S.C., Porembka, M.R. et al. Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis. J Gastrointest Surg 21, 1784–1792 (2017). https://doi.org/10.1007/s11605-017-3543-6

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  • DOI: https://doi.org/10.1007/s11605-017-3543-6

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