The surgical outcomes of robot-assisted laparoscopic pancreaticoduodenectomy versus laparoscopic pancreaticoduodenectomy for periampullary neoplasms: a comparative study of a single center

Surg Endosc. 2017 Jun;31(6):2380-2386. doi: 10.1007/s00464-016-5238-6. Epub 2016 Sep 8.

Abstract

Background: Pancreaticoduodenectomy (PD) is a difficult and complex operation. The introduction of robotics has opened up new angles in pancreatic surgery. This study aims to assess the surgical outcomes of robot-assisted laparoscopic pancreaticoduodenectomy relative to its laparoscopic counterpart.

Methods: A retrospective study was designed to compare the surgical outcomes of 27 robot-assisted laparoscopic pancreaticoduodenectomy (RPD) and 25 laparoscopic pancreaticoduodenectomy (LPD). Perioperative data, including operating time, complication, morbidity and mortality, estimated blood loss, and postoperative length of stay, were analyzed.

Results: The robotic group exhibited significantly shorter operative time (mean 387 vs. 442 min), shorter hospital stay (mean 17 vs. 24 days), and less blood loss (mean 219 vs. 334 ml) than those in the LPD group. No statistical difference was observed between the two groups in terms of complication rate, mortality rate, R0 resection rate, and number of harvested lymph node.

Conclusions: RPD is more efficient and secure process than LPD among properly selected patients. RPD is therefore a feasible alternative to the laparoscopic procedure. Further studies are needed to evaluate the cost effectiveness of the robotic approach for PD.

Keywords: Comparative study; Laparoscopic pancreaticoduodenectomy; Periampullary neoplasms; Robotic surgery; da Vinci.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Adult
  • Aged
  • Ampulla of Vater
  • Carcinoma / surgery*
  • Common Bile Duct Neoplasms / surgery*
  • Female
  • Humans
  • Laparoscopy / methods*
  • Male
  • Middle Aged
  • Neuroendocrine Tumors / surgery*
  • Pancreatic Neoplasms / surgery*
  • Pancreaticoduodenectomy / methods*
  • Retrospective Studies
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome