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Reduced-port robotic pancreaticoduodenectomy versus open pancreaticoduodenectomy: a single-surgeon experience

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Abstract

Background and objectives

Multiple-port robotic pancreaticoduodenectomy (RPD) has been increasingly used as an alternative to open pancreaticoduodenectomy (OPD) in pancreatic cancer. However, the comparative safety and efficacy of reduced-port RPD versus OPD are unknown.

Methods

This was a prospective cohort study comprising adult patients who underwent reduced-port RPD (single-port or single-site plus one port) or OPD for malignant tumors of the pancreas and periampullary region from July 2015 to October 2020 at a single center. We collected data on the patient demographics, perioperative results, oncologic outcomes, and one-year survival.

Results

Forty-five patients underwent reduced-port RPD, and 13 underwent OPD. There were no significant differences in the age, sex, body mass index, ASA score, tumor location, or occurrences of postoperative complications between the two groups. Compared with OPD, reduced-port RPD was associated with less blood loss (300 ml [95% confidence interval {CI} 155–700] vs. 650 ml [95% CI 300–850], p value = 0.11) but a longer operative time (325 min [95% CI 290–370] vs. 215 min [95% CI 180–270], p value < 0.001). Compared with patients who underwent OPD, patients who underwent reduced-port RPD had a higher 1-year survival rate (68% [95% CI 49–81] vs. 22% [95% CI 3–51], log-rank, p value = 0.007).

Conclusions

Reduced-port RPD can be safely performed in experienced surgeons and is associated with better perioperative and oncologic outcomes than OPD.

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Acknowledgements

The authors thank the Department of Pathology at Chung Shan Medical University Hospital for their technical assistance.

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Author notes

  1. Cho-Han Chiang and Cho-Hsien Chiang contributed equally.

Authors and Affiliations

  1. Master of Medical Sciences in Clinical Investigation, Harvard Medical School, Boston, MA, USA

    Cho-Han Chiang

  2. School of Medicine, National Taiwan University College of Medicine, Taipei, Taiwan

    Cho-Han Chiang

  3. Department of Medicine, Chung Shan Medical University, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan

    Cho-Hsien Chiang, Ching-Lung Hsieh, Jhong-I. Peng & Cheng-Ming Peng

  4. Da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, No. 110, Sec. 1, Chien-Kuo N. Rd., Taichung, 40201, Taiwan

    Cho-Hsien Chiang, Teng-Chieh Cheng, Ching-Lung Hsieh, Jhong-I. Peng & Cheng-Ming Peng

  5. Division of General Medicine, Taipei Tzu Chi Hospital, Buddhist Tzu Chi Foundation, New Taipei City, Taiwan

    Cho-Hung Chiang

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Correspondence to Cheng-Ming Peng.

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Chiang, CH., Chiang, CH., Cheng, TC. et al. Reduced-port robotic pancreaticoduodenectomy versus open pancreaticoduodenectomy: a single-surgeon experience. Surg Today 52, 896–903 (2022). https://doi.org/10.1007/s00595-021-02408-0

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  • DOI: https://doi.org/10.1007/s00595-021-02408-0

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