Short-term outcomes of robotic pancreaticoduodenectomy during implementation stage: A comparison with open surgery
TL;DR
The implementation stage of robot-assisted pancreaticoduodenal resection has already demonstrated a positive trend, including a reduction in the number of wound complications, the incidence of pancreatic fistulas, and the length of hospital stay, as well as an increase in the rate of achieving the target outcome.
Abstract
Aim. To evaluate the short-term outcomes of robotic pancreaticoduodenectomy during the implementation stage compared with open pancreatoduodenal resection. Material and methods. A single-center, retrospective cohort study was conducted. The study analyzed the outcomes of 114 open and 52 robotic pancreaticoduodenectomy procedures performed between 2017 and 2025. To reduce the risk of systematic error, Propensity Score Matching (PSM) was performed. Results. The majority of the measured parameters were comparable. The median operative time in the robotic pancreaticoduodenectomy group was significantly longer both before and after PSM ( p = 0.013). No statistically significant differences were observed in the incidence of postoperative complications classified as Clavien-Dindo ≥3, the median cumulative complication index, or in-hospital mortality. Prior to PSM, the robotic pancreaticoduodenectomy group exhibited a significantly lower incidence of wound complications (3.8 % vs. 14 %). However, after PSM, the differences were not statistically significant ( p = 0.141). The results of the PSM procedure indicated a lower incidence of pancreatic fistula in the robotic-assisted pancreas surgery group (25 % vs. 33.3 %; p = 0.071). Following PSM, the in-hospital mortality ratewas recorded as 4.9 % and 7.6 %, respectively ( p = 0.169). In the group that underwent robotic pancreaticoduodenectomy, four deaths occurred among the initial 30 surgeries. Subsequent mortality was not observed. Conclusion. After performing more than 50 robotic pancreatoduodenectomy procedures, satisfactory results comparable to those of open surgery were achieved. Moreover, the implementation stage of robot-assisted pancreaticoduodenal resection has already demonstrated a positive trend, including a reduction in the number of wound complications, the incidence of pancreatic fistulas, and the length of hospital stay, as well as an increase in the rate of achieving the target outcome.