Short-term surgical outcomes of open, laparoscopic, and robot-assisted pancreatoduodenectomy: A comparative, single-center, retrospective study

IF 0.9 Q4 ORTHOPEDICS

Asian Journal of Endoscopic Surgery Pub Date : 2024-10-20 DOI:10.1111/ases.13397

Naohisa Kuriyama, Takehiro Fujii, Benson Kaluba, Tatsuya Sakamoto, Haruna Komatsubara, Daisuke Noguchi, Takahiro Ito, Aoi Hayasaki, Yusuke Iizawa, Yasuhiro Murata, Akihiro Tanemura, Masashi Kishiwada, Shugo Mizuno

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引用次数: 0

Abstract

Purpose

Although laparoscopic pancreaticoduodenectomy (LPD) and robot-assisted pancreaticoduodenectomy (RPD) are gradually gaining popularity, their advantages over open pancreaticoduodenectomy (OPD) remain controversial. This study aimed to compare the short-term outcomes of OPD, LPD, and RPD to elucidate the advantages and disadvantages of each procedure.

Methods

We retrospectively analyzed 16 LPD, 43 RPD, and 36 OPD procedures performed at a single center between April 2020 and May 2024. Clinical data, including operative time, estimated blood loss, postoperative complications, length of hospital stay, and hospitalization costs, were retrospectively collected and analyzed.

Results

RPD demonstrated a significantly longer operative time (553 min) than OPD (446 min) and LPD (453 min) but a significantly lower estimated blood loss than OPD (150 mL vs. 400 mL, p < .001). Postoperative complication rates (Clavien–Dindo grade ≥3) were lower for RPD (24.4%) than those for OPD (50.0%) and LPD (68.8%). RPD also showed a significantly lower rate of clinically relevant postoperative pancreatic fistula (14.6% vs. 38.9% for OPD and 43.8% for LPD) and a shorter duration of hospitalization (11 vs. 28 days for OPD and 21 days for LPD, p < .001). Hospitalization costs were higher for RPD (20 109 USD) than for OPD (18 487 USD, p < .001), with LPD (20 496 USD) and RPD costs being similar.

Conclusions

RPD appears to offer advantages in terms of reduced blood loss and postoperative complications and shortened hospital stay despite longer operative times and higher hospitalization costs. Therefore, RPD may be a more beneficial approach than OPD or LPD in pancreatic surgery.

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开腹、腹腔镜和机器人辅助胰十二指肠切除术的短期手术效果：单中心回顾性对比研究

目的虽然腹腔镜胰十二指肠切除术（LPD）和机器人辅助胰十二指肠切除术（RPD）逐渐受到欢迎，但它们与开腹胰十二指肠切除术（OPD）相比的优势仍存在争议。本研究旨在比较 OPD、LPD 和 RPD 的短期疗效，以阐明每种手术的优缺点。方法我们回顾性分析了 2020 年 4 月至 2024 年 5 月期间在一个中心进行的 16 例 LPD、43 例 RPD 和 36 例 OPD 手术。我们回顾性地收集并分析了临床数据，包括手术时间、估计失血量、术后并发症、住院时间和住院费用。结果 RPD 的手术时间（553 分钟）明显长于 OPD（446 分钟）和 LPD（453 分钟），但估计失血量明显低于 OPD（150 毫升对 400 毫升，p < .001）。术后并发症发生率（Clavien-Dindo 分级≥3），RPD（24.4%）低于 OPD（50.0%）和 LPD（68.8%）。RPD 的术后胰瘘临床相关率也明显较低（14.6% 对 OPD 的 38.9% 和 LPD 的 43.8%），住院时间也较短（11 天对 OPD 的 28 天和 LPD 的 21 天，p < .001）。RPD 的住院费用（20 109 美元）高于 OPD（18 487 美元，p < .001），LPD（20 496 美元）和 RPD 的费用相近。结论尽管手术时间较长，住院费用较高，但 RPD 似乎在减少失血量、术后并发症和缩短住院时间方面更具优势。因此，在胰腺手术中，RPD 可能是比 OPD 或 LPD 更为有益的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Asian Journal of Endoscopic Surgery ORTHOPEDICS-

CiteScore

2.00

自引率

10.00%

发文量

129