Robotic vs open distal pancreatectomy: A multi-institutional matched comparison analysis (2024)

Background: Pancreatic surgery is still a challenge even in high-volume centers.Clinically relevant postoperative pancreatic fistula (CR-POPF) represents the greatest contributor to major morbidity and mortality, especially following pancreaticdistal resection. In this study, we compared robotic distal pancreatectomy (RDP) toopen distal pancreatectomy (ODP) in terms of CR-POPF development and analyzedoncologic efficacy of RDP in the subgroup of patients with pancreatic ductal adenocarcinoma (PDAC).Methods: We collected data from five high-volume centers for pancreatic surgeryand performed a matched comparison analysis to compare short and long-term outcomes after ODP or RDP. Patients were matched with a 2:1 ratio according to age,ASA (American Society of Anesthesiologists) score, body mass index (BMI), finalpathology, and TNM (Tumour, Node, Metastasis) staging system VIII ed.Results: Two hundred and forty-six patients who underwent 82 RDPs and 164 ODPswere included. No differences were found in the incidence of CR-POPF. In thePDAC group, median DFS and OS were 10.8 months and 14.8 months in the ODPgroup and 10.4 months and 15 months in the RDP group, respectively.Conclusions: Robotic distal pancreatectomy is a safe surgical strategy for PDACand incidence of CR-POPF is equivalent between RDP and ODP. RDP should beconsidered equivalent to ODP in terms of oncological efficacy when performed inhigh-volume and proficient centers.

Robotic vs open distal pancreatectomy: A multi-institutional matched comparison analysis / Magistri, Paolo; Boggi, Ugo; Esposito, Alessandro; Carrano, F; Pesi, Benedetta; Ballarin, Roberto; De Pastena, Matteo; Menonna, Francesca; Moraldi, Luca; Melis, Marcovalerio; Coratti, Andrea; Newman, Elliot; Napoli, Niccolò; Ramera, Marco; Di Benedetto, Fabrizio. - In: JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES. - ISSN 1868-6982. - 28:12(2021), pp. 1098-1106. [10.1002/jhbp.881]

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