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Background <p>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).</p> Method <p>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&#xa0;years were included. Data for the outcomes of interest were extracted.</p> Results <p>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]; <i>p = </i>0.001), wound infections (RR = 0.63, 95% CI: [0.49–0.81], <i>p = </i>0.0004), estimated blood loss (WMD = -171.99&#xa0;ml, 95% CI: [ -217.76 to -126.22], <i>p &lt; </i>0.01) and hospitalization duration (WMD = -1.33&#xa0;days, 95% CI: [ -1.84 to -0.82], <i>p &lt; </i>0.01) with a longer operating time (WMD = 73.22&#xa0;min, 95% CI: [56.20 to 90.23], <i>p &lt; </i>0.01).</p> Conclusion <p>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.</p>

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Comparing Operative Outcomes and Resection Quality in Robotic vs Open Pancreaticoduodenectomy: A Meta-analysis of 54,000 Patients

  • 期刊论文

  • 发表日期：

    2025年1月29日

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  • Muhammad Hassan Waseem,
  • Zain ul Abideen,
  • Rafia Durrani,
  • Esha Dilawar,
  • Mohammad Saboor Kamran,
  • Hassan Tariq Butt,
  • Haseeb Javed Khan,
  • Abdul Ahad,
  • Pakeeza Shakoor,
  • Hema Kumari Jeswani,
  • Syeda Aliza Kazmi,
  • Ibrahim Mughees,
  • Muhammad Ali,
  • Muhammad Arslan Tariq,
  • Shurjeel Uddin Qazi

摘要

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.