Robotic pancreaticoduodenectomy: comparison of complications and cost to the open approach

Background Robotic pancreaticoduodenectomy (RP) has shown some advantages over open pancreaticoduodenectomy (OP) but no data has been published providing a cost comparison. Methods Retrospective analysis of all pancreaticoduodenectomies at a single quaternary cancer referral center was performed. Patient demographics, comorbidities, operative characteristics, complications, and charge data were recorded, and then compared using standard statistical methods. Results 71 pancreaticoduodenectomies were performed: 22 RP and 49 OP. Patients undergoing OP had similar demographics, comorbidities, pathology, and oncologic characteristics as patients undergoing RP. While operative charges were higher for RP, once inpatient stay associated costs and followup costs were included, there was no difference in total costs between RP and OP. Conclusions Patients undergoing RP have equivalent rates of R0 resection as OP, and benefit from decreased number of complications, surgical site infections, and length of stay in the intensive care unit. Once cost of complications and follow-up are incorporated, no significant difference between procedures exists. Copyright (C) 2015 John Wiley & Sons, Ltd.