Liu Faying, Zou Yang, Chen Qing, Chen Tao, Xiao He, Xie Tingbing, Zheng Lihe, Ruan Qi, Liu Wang
Department of General Surgery, ChengFei Hospital, Chengdu, Sichuan, China.
Front Oncol. 2025 Jun 18;15:1568957. doi: 10.3389/fonc.2025.1568957. eCollection 2025.
Minimally invasive pancreaticoduodenectomy is becoming more and more popular among surgeons, but whether robotic pancreatoduodenectomy (RPD) is superior to laparoscopic surgery remains controversial. The study aims to assess the available literature and compare the perioperative outcomes of RPD and laparoscopic pancreatoduodenectomy (LPD).
A systematic literature search was performed in the PubMed, Cochrane Library, Embase, Web of Science databases (October 2024). Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
The 29 studies that met inclusion criteria included 15137 PDs, out of which 8935 were LPD and 6202 were RPD. Compared with LPD, RPD has lower overall complications (RR, 0.87), conversion rates (RR, 0.47) and blood transfusion rates (RR, 0.56), shorter length of stay (MD, -0.80 days), and higher number of harvested lymph nodes (MD, 1.77). There were no significant differences observed in 90-day mortality (RR, 0.92), major complications (RR, 1.00), operative time (MD, 3.93 mins), blood loss (MD, -22.50 mL), reoperation (RR, 0.96), bile leak (RR, 0.87), postoperative pancreatic fistula (RR, 1.00), delayed gastric emptying (RR, 1.19), and R0 resection (RR, 0.99) between the groups.
Robotic-assisted surgery for PD is safe and feasible. Compared to LPD, it offers better short-term outcomes.
微创胰十二指肠切除术在外科医生中越来越受欢迎，但机器人胰十二指肠切除术（RPD）是否优于腹腔镜手术仍存在争议。本研究旨在评估现有文献，并比较RPD和腹腔镜胰十二指肠切除术（LPD）的围手术期结果。
于2024年10月在PubMed、Cochrane图书馆、Embase、科学网数据库中进行系统的文献检索。计算风险比（RRs）和平均差（MDs）以及95%置信区间（CIs）。
符合纳入标准的29项研究包括15137例胰十二指肠切除术，其中8935例为LPD，6202例为RPD。与LPD相比，RPD的总体并发症（RR，0.87）、中转率（RR，0.47）和输血率（RR，0.56）更低，住院时间更短（MD，-0.80天），收获的淋巴结数量更多（MD，1.77）。两组在90天死亡率（RR，0.92）、主要并发症（RR，1.00）、手术时间（MD，3.93分钟）、失血量（MD，-22.50毫升）、再次手术（RR，0.96）、胆漏（RR，0.87）、术后胰瘘（RR，1.00）、胃排空延迟（RR，1.19）和R0切除（RR，0.99）方面未观察到显著差异。
机器人辅助胰十二指肠切除术安全可行。与LPD相比，它具有更好的短期结果。
