Robotic pancreaticoduodenectomy for pancreatic ductal adenocarcinoma: Analysis of surgical outcomes and long-term prognosis in a high-volume center

Zhang, Xiuping; Xu, Shuai; Zhao, Zhiming; Liu, Qu; Zhao, Guodong; Hu, Minggen; Tan, Xiaojie; Liu, Rong

doi:10.1016/j.hbpd.2022.09.006

Cited by 4 publications

(1 citation statement)

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“…In recent years, rapid progress in minimally invasive pancreatic surgery has led to many centers to report on their initial experiences on LPD [ 9 – 11 ]. And, since robotic surgery allows for more flexible and precise manipulation of instruments and 3D visualization, a growing number of hospitals are also experimenting with robotic pancreaticoduodenectomy (RPD) [ 26 , 30 ]. Our team has also participated in a multicenter, open-label, randomized controlled trial (RCT) which showed that LPD to be associated with a shorter LOS and similar rates of short-term morbidity and mortality as OPD [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Short‑ and long‑term outcomes after laparoscopic and open pancreatoduodenectomy for elderly patients: a propensity score‑matched study

Xu,

Deng,

Wang

et al. 2024

BMC Geriatr

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Background The feasibility and safety of laparoscopic pancreatoduodenectomy (LPD) in elderly patients is still controversial. This study aimed to compare the clinical outcomes of LPD and open pancreatoduodenectomy (OPD) in elderly patients. Methods Clinical and follow-up data of elderly patients (≥ 65 years) who underwent LPD or OPD between 2015 and 2022 were retrospectively analyzed. A 1:1 propensity score-matching (PSM) analysis was performed to minimize differences between groups. Univariate and multivariate logistic regression analysis were used to select independent prognostic factors for 90-day mortality. Results Of the 410 elderly patients, 236 underwent LPD and 174 OPD. After PSM, the LPD group had a less estimated blood loss (EBL) (100 vs. 200 mL, P < 0.001), lower rates of intraoperative transfusion (10.4% vs. 19.0%, P = 0.029), more lymph node harvest (11.0 vs. 10.0, P = 0.014) and shorter postoperative length of stay (LOS) (13.0 vs. 16.0 days, P = 0.013). There were no significant differences in serious complications, reoperation, 90-day readmission and mortality rates (all P > 0.05). Multivariate logistic regression analysis showed that post-pancreatectomy hemorrhage (PPH) was an independent risk factor for 90-day mortality. Elderly patients with pancreatic ductal adenocarcinoma (PDAC) who underwent LPD or OPD had similar overall survival (OS) (22.5 vs.20.4 months, P = 0.672) after PSM. Conclusions It is safe and feasible for elderly patients to undergo LPD with less EBL and a shorter postoperative LOS. There was no statistically significant difference in long-term survival outcomes between elderly PDAC patients who underwent LPD or OPD.

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