Robot-assisted laparoscopic pancreaticoduodenectomy versus open pancreaticoduodenectomy - A comparative study

Background: Traditionally, pancreatic surgery is considered as one of the most complex surgeries. The recently developed robotic technology allows surgeons to perform pancreaticoduodenectomy. A comparative study was undertaken to study outcomes between robotic approach and open approach. Methods: A consecutive patients underwent pancreaticoduodenectomy (robotic approach, n = 20; open approach = 67) between January 2000 and February 2012 at a single institution were analyzed. Results: The robotic group had a significantly longer operative time (mean, 491.5 vs. 264.9 min), reduced blood loss (mean, 247 vs. 774.8 ml), and shorter hospital stay (mean, 13.7 vs. 25.8 days) compared to the open group. Open conversion rate was 5%. There was no significant difference between the two groups in terms of overall complication rates, mortality rates, R0 resection rate and harvested lymph node numbers. Conclusions: This study showed that robot-assisted laparoscopic pancreaticoduodenectomy was safe and feasible in appropriately selected patients. However, it is too early to draw definitive conclusions about the value of robot-assisted laparoscopic pancreaticoduodenectomy. In light of remaining uncertainties regarding short-term and long-term outcome, caution should be exercised in the assessment of the appropriateness of this operation for individual patient. (C) 2012 Surgical Associates Ltd. Published by Elsevier Ltd. All rights reserved.