Lyu Heather G, Hirata Yuki, Lu Pamela W, Maxwell Jess E, Snyder Rebecca A, Kim Michael P, Tran Cao Hop, Tzeng Ching-Wei D, Katz Matthew H G, Ikoma Naruhiko
Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston Texas USA.
Ann Gastroenterol Surg. 2025 Apr 3;9(5):1066-1074. doi: 10.1002/ags3.70017. eCollection 2025 Sep.
Costs associated with robotic pancreatectomy compared to those of open pancreatectomy are assumed to be high but are not well known, particularly during the initial implementation of the robot.
Patients who underwent pancreatectomy for any diagnosis from January 2017 to August 2021 were identified retrospectively. Total hospital cost was calculated using intraoperative, inpatient, and outpatient costs within 30 days of surgery. The ratio of the total cost of each pancreatectomy to the average cost of all operations at our center was used to represent cost without sharing proprietary financial data. Propensity score matching was performed to account for significant differences between the two groups.
We identified 679 patients who underwent pancreatectomies, 88 of which were robotic. After propensity score matching, the open cohort had 176 patients, and the robotic cohort remained at 88 patients. The median hospital length of stay was 2 days shorter for robotic than for open pancreatectomy ( < 0.001). The total hospital cost was markedly lower in the robotic pancreatectomy cohort. The inpatient and outpatient costs for robotic pancreatectomy were considerably lower than those for open pancreatectomy despite substantially higher intraoperative costs for the former procedure. A scatter plot of total costs after the initial adoption of the robot showed a trend of decreasing costs over time.
Overall, total hospital costs associated with robotic pancreatectomy were lower than those for open surgery, mainly driven by shorter length of stay. Our findings suggest that costs of robotic pancreatectomy may decrease further with increased surgeon experience.
与开放性胰腺切除术相比，机器人辅助胰腺切除术的成本被认为较高，但具体情况尚不明确，尤其是在机器人手术最初开展阶段。
回顾性分析2017年1月至2021年8月期间因任何诊断接受胰腺切除术的患者。使用手术30天内的术中、住院和门诊费用计算总住院费用。为避免分享专有财务数据，用每种胰腺切除术的总成本与本中心所有手术平均成本的比值来表示成本。采用倾向得分匹配法以消除两组之间的显著差异。
我们确定了679例行胰腺切除术的患者，其中88例为机器人辅助手术。倾向得分匹配后，开放性手术组有176例患者，机器人辅助手术组仍为88例患者。机器人辅助胰腺切除术的中位住院时间比开放性胰腺切除术短2天（<0.001）。机器人辅助胰腺切除术组的总住院费用明显更低。尽管机器人辅助胰腺切除术的术中费用大幅高于开放性胰腺切除术，但其住院和门诊费用却显著更低。机器人手术最初应用后的总成本散点图显示成本随时间呈下降趋势。
总体而言，机器人辅助胰腺切除术的总住院费用低于开放性手术，主要原因是住院时间较短。我们的研究结果表明，随着外科医生经验的增加，机器人辅助胰腺切除术的成本可能会进一步降低。
