ROBOT‐assisted pancreatoduodenectomy in 300 consecutive cases: Annual trend analysis and propensity score‐matched comparison of perioperative and long‐term oncologic outcomes with the open method

Kim, Hyeong Seok; Kim, Hongbeom; Han, Youngmin; Lee, Mirang; Kang, Yoon Hyung; Sohn, Hee Ju; Kang, Jae Seung; Kwon, Wooil; Jang, Jin‐Young

doi:10.1002/jhbp.1065

Cited by 7 publications

(1 citation statement)

References 22 publications

(59 reference statements)

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“…Studies on the learning curve and training for MIPD have emphasized the need for an MIPD registry to gather evidence for clinical research 11 – 13 . Korean groups have published studies on MIPD and collaborated to establish a registry in line with global trends 9 , 14 – 18 . After the establishment of the Korean study group on Minimally Invasive Pancreatic Surgery (K-MIPS) in 2019 ( http://kmips.or.kr/index.html ), patients who underwent MIPS were retrospectively and prospectively registered.…”

Section: Introductionsmentioning

confidence: 99%

Perioperative textbook outcomes of minimally invasive pancreatoduodenectomy: a multicenter retrospective cohort analysis in a Korean minimally invasive pancreatic surgery registry

Kwon,

Kang,

Jang

et al. 2024

International Journal of Surgery

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Background: The aim of this study is to investigate the perioperative composite textbook outcomes of pancreatic surgery after minimally invasive pancreatoduodenectomy (MIPD). Materials and methods: The cohort study was conducted across 10 institutions and included 1552 patients who underwent MIPD registered with the Korean Study Group on Minimally Invasive Pancreatic Surgery between May 2007 and April 2020. We analyzed perioperative textbook outcomes of pancreatic surgery after MIPD. Subgroup analyses were performed to assess outcomes based on the hospital volume of MIPD. Results: Among all patients, 21.8% underwent robotic pancreatoduodenectomy. High-volume centers (performing >20 MIPD/year) performed 88.1% of the procedures. The incidence of clinically relevant postoperative pancreatic fistula was 11.5%. Severe complications (Clavien–Dindo grade ≥IIIa) occurred in 15.1% of the cases. The 90-day mortality rate was 0.8%. The mean hospital stay was 13.7 days. Textbook outcomes of pancreatic surgery success were achieved in 60.4% of patients, with higher rates observed in high-volume centers than in low-volume centers (62.2% vs. 44.7%, P<0.001). High-volume centers exhibited significantly lower conversion rates (5.4% vs. 12.5%, P=0.001), lower 90-day mortality (0.5% vs. 2.7%, P=0.001), and lower 90-day readmission rates (4.5% vs. 9.6%, P=0.006) than those low-volume centers. Conclusion: MIPD could be performed safely with permissible perioperative outcomes, including textbook outcomes of pancreatic surgery, particularly in experienced centers. The findings of this study provided valuable insights for guiding surgical treatment decisions in periampullary disease.

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Section: Introductionsmentioning

confidence: 99%

Perioperative textbook outcomes of minimally invasive pancreatoduodenectomy: a multicenter retrospective cohort analysis in a Korean minimally invasive pancreatic surgery registry

Kwon,

Kang,

Jang

et al. 2024

International Journal of Surgery

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Current trends in types of pancreatoduodenectomy: Focus on the advancement of robot‐assisted pancreatoduodenectomy with 630 consecutive cases

Lee,

Chae,

Park

et al. 2024

J Hepato Biliary Pancreat

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BackgroundPancreatoduodenectomy (PD) is a complex abdominal surgery, and the adoption of robotic PD has been on the rise because of its numerous benefits. This study aimed to investigate the current PD trends, focusing on advancements in robotic surgery.MethodsBetween 2015 and 2023, 1231 patients underwent open PD, whereas 630 underwent robot‐assisted PD (RAPD). Demographics and surgical outcomes were analyzed according to the time period. Moreover, a propensity score‐matched (PSM) analysis was performed to evaluate the clinical outcomes.ResultsThe proportion of RAPD cases gradually increased from 6.3% in 2015 to 50.9% in 2020, reaching a plateau of >50% thereafter. The proportion of patients receiving neoadjuvant chemotherapy increased during the late period (11.4% vs. 17.6%), with many of these patients undergoing open PD. Additionally, RAPD was performed in patients with a high probability of postoperative pancreatic fistula. However, the two groups demonstrated no significant difference in the occurrence of clinically relevant postoperative pancreatic fistula (10.6% vs. 9.5%, p = .532). Among periampullary cancer cases, RAPD demonstrated comparable survival outcomes to open PD after PSM (5‐year survival rate: 61.8% vs. 49.8%, p = .189).ConclusionsRAPD has become a stable approach, accounting for over 50% of all PD cases in high‐volume centers, and it can be safely performed. However, open PD remains important owing to the development of neoadjuvant therapy and the aging population. Therefore, establishing appropriate indications to maximize the benefits of both RAPD and open PD is necessary.

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The safety and feasibility of robotic pancreaticoduodenectomy: A multicenter retrospective assessment of 425 patients in Japan

Nakamura,

Nakata,

Nagakawa

et al. 2024

J Hepato Biliary Pancreat

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Background/PurposeThe Japanese public health insurance system has recently covered robotic pancreaticoduodenectomy (RPD). This study aimed to review the results of RPD during the introductory period and elucidate its safety and feasibility in Japan.MethodsConsecutive data of 425 patients who underwent RPD were retrospectively collected from 10 high‐volume centers in Japan between April 2020 and September 2022. The primary endpoints were the rates of conversion to open surgery and completion of minimally invasive surgery (MIS), defined as the use of a totally robotic operation or combined robotic and laparoscopic procedures. Secondary endpoints were operative time, blood loss, complication rate, and 30‐ and 90‐day mortality rates.ResultsStudy comprised 222 males and 203 females, with a median age of 70 (p10–p90; 50–81) years. The conversion to open surgery and completion rates of MIS were 3.8% (16 patients) and 91.1% (387 patients), respectively. The median operative time was 617 min (p10–p90; 456–834 min), and the median volume of blood loss was 160 g (p10–p90; 30–558 g). The complication rate (Clavien‐Dindo classification grade ≥ IIIa) was 20.5%. The 30‐ and 90‐day mortality rates were 0.2% and 0.5%, respectively.ConclusionsOur results indicate that RPD can be introduced successfully and is a promising approach for pancreaticoduodenectomy.

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ROBOT‐assisted pancreatoduodenectomy in 300 consecutive cases: Annual trend analysis and propensity score‐matched comparison of perioperative and long‐term oncologic outcomes with the open method

Cited by 7 publications

References 22 publications

Perioperative textbook outcomes of minimally invasive pancreatoduodenectomy: a multicenter retrospective cohort analysis in a Korean minimally invasive pancreatic surgery registry

Perioperative textbook outcomes of minimally invasive pancreatoduodenectomy: a multicenter retrospective cohort analysis in a Korean minimally invasive pancreatic surgery registry

Current trends in types of pancreatoduodenectomy: Focus on the advancement of robot‐assisted pancreatoduodenectomy with 630 consecutive cases

The safety and feasibility of robotic pancreaticoduodenectomy: A multicenter retrospective assessment of 425 patients in Japan

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