Comparing operative outcomes and resection quality in robotic vs open pancreaticoduodenectomy: A meta-analysis of 54,000 patients
Document Type
Review Article
Department
Centre for Innovation in Medical Education
Abstract
Background: High morbidity and mortality make pancreaticoduodenectomy (PD) one of the most complicated surgical procedures. This meta-analysis aimed to compare the outcomes of robotic pancreaticoduodenectomy (RPD) versus open pancreaticoduodenectomy (OPD).
Method: A comprehensive literature search of PubMed, Cochrane Central, and Google Scholar was conducted from inception to November 2024. Studies comparing RPD and OPD in adults aged ≥ 18 years were included. Data for the outcomes of interest were extracted.
Results: Forty-one studies with a total of 54,287 patients were pooled. RPD is significantly superior to OPD in terms of overall postoperative complications (RR = 0.91, 95% CI: [0.86-0.97]; p = 0.001), wound infections (RR = 0.63, 95% CI: [0.49-0.81], p = 0.0004), estimated blood loss (WMD = -171.99 ml, 95% CI: [ -217.76 to -126.22], p < 0.01) and hospitalization duration (WMD = -1.33 days, 95% CI: [ -1.84 to -0.82], p < 0.01) with a longer operating time (WMD = 73.22 min, 95% CI: [56.20 to 90.23], p < 0.01).
Conclusion: In conclusion, RPD shows a lower risk of wound infections and overall postoperative morbidity compared to OPD. It has lower estimated blood loss, shorter hospitalization duration, and a longer operating time. The two approaches were comparable in terms of resection quality. More high-quality RCTs are required to draw definite conclusions.
Publication (Name of Journal)
Journal of Gastrointestinal Cancer
DOI
10.1007/s12029-025-01177-0
Recommended Citation
Waseem, M. H.,
Abideen, Z. u.,
Durrani, R.,
Dilawar, E.,
Kamran, M. S.,
Butt, H. T.,
Khan, H. J.,
Ahad, A.,
Shakoor, P.,
Jeswani, H. K.,
Kazmi, S. A.,
Mughees, I.,
Ali, M.,
Tariq, M. A.,
Qazi, S. U.
(2025). Comparing operative outcomes and resection quality in robotic vs open pancreaticoduodenectomy: A meta-analysis of 54,000 patients. Journal of Gastrointestinal Cancer, 56(57), 1-16.
Available at:
https://ecommons.aku.edu/cime/17