From the The Liver Institute.
Methodist Digestive Institute, Methodist Dallas Medical Center.
Pancreas. 2020 May/Jun;49(5):668-674. doi: 10.1097/MPA.0000000000001545.
The value of robotic pancreaticoduodenectomy (RPD) remains undefined. The aim of this retrospective study was to compare and assess clinical outcomes and financial variables of patients undergoing RPD versus open pancreaticoduodenectomy (OPD) at a single high-volume center.
The study design is a retrospective analysis of a prospectively maintained database of consecutive PD patients from 2013 to 2019. Clinical variables and total hospital charges were evaluated as an unadjusted and adjusted intention-to-treat analysis.
A total of 156 patients (54 OPD, 102 RPD) were identified. In the RPD group, patients were significantly older (P = 0.0304) and had shorter length of stay (mean, 7 vs 11.8 days; P < 0.0001) and longer operative times (mean, 352.7 vs 211.5 minutes; P < 0.0001) compared with OPD. There was no significant difference in 90-day readmissions, bleeding, or complications between OPD and RPD. Adjusted charge analyses show no difference in total charges (P = 0.057).
Robotic pancreaticoduodenectomy is safe, feasible, and valid alternative to OPD. Because of comparable results within each group, randomized trials may be indicated. High-volume RPD centers should collaborate to better understand the differences and advantages over laparoscopic or OPD.
机器人胰十二指肠切除术（RPD）的价值仍未确定。本回顾性研究的目的是比较和评估单一高容量中心接受 RPD 与开放式胰十二指肠切除术（OPD）的患者的临床结果和财务变量。
研究设计是对 2013 年至 2019 年连续 PD 患者前瞻性维护数据库的回顾性分析。作为意向治疗分析，评估了临床变量和总住院费用。
共确定了 156 例患者（54 例 OPD，102 例 RPD）。在 RPD 组中，患者的年龄明显更大（P = 0.0304），住院时间更短（平均 7 天 vs 11.8 天；P <0.0001），手术时间更长（平均 352.7 分钟 vs 211.5 分钟；P <0.0001）与 OPD。OPD 和 RPD 之间在 90 天再入院率、出血或并发症方面无显着差异。调整后的费用分析显示总费用无差异（P = 0.057）。
机器人胰十二指肠切除术是 OPD 的安全、可行和有效的替代方法。由于每组内结果相当，可能需要进行随机试验。高容量的 RPD 中心应合作，以更好地了解其与腹腔镜或 OPD 的差异和优势。
