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Multicenter comparison of totally laparoscopic and totally robotic pancreaticoduodenectomy: Propensity score and learning curve-matching analyses

Authors
 Hyeyeon Kim  ;  Sung Hoon Choi  ;  Jae Young Jang  ;  Munseok Choi  ;  Jae Hoon Lee  ;  Chang Moo Kang 
Citation
 JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES, Vol.29(3) : 311-321, 2022-03 
Journal Title
JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
ISSN
 1868-6974 
Issue Date
2022-03
MeSH
Humans ; Laparoscopy* / adverse effects ; Learning Curve ; Length of Stay ; Pancreatic Neoplasms* / surgery ; Pancreaticoduodenectomy / adverse effects ; Pancreaticoduodenectomy / methods ; Postoperative Complications / surgery ; Propensity Score ; Retrospective Studies ; Robotic Surgical Procedures* / adverse effects
Keywords
laparoscopic ; minimally invasive ; pancreaticoduodenectomy ; robotic
Abstract
Background: Few studies have compared laparoscopic pancreaticoduodenectomy (LPD) and robotic pancreaticoduodenectomy (RPD) despite emerging use of minimally invasive pancreaticoduodenectomy (MIPD). The present study therefore compares perioperative outcomes of LPD and RPD patients, and evaluates safety and feasibility of MIPD.

Methods: This retrospective multicenter analysis evaluated MIPD patients through June 2020 performed by three experienced pancreatic surgeons at three different institutions. Perioperative outcomes were compared before and after propensity score-matching analyses, and learning curves based on operation time were used for additional matching analysis.

Results: Of 362 patients, 282 underwent LPD and 80 underwent RPD. Open conversion rate was significantly higher in LPD (P = .001). There were no significant differences in rates of major complications (Clavien-Dindo ≥III) and clinically relevant postoperative pancreatic fistula (CR-POPF). After matching, operation time (P = .001) and hospital stay (P = .027) were significantly shorter in RPD, but there were no differences in major complications and CR-POPF. Propensity score-matched comparison after learning curve attainment showed shorter operation time (P = .037) and hospital stay (P = .014) in RPD, and no differences in major complications and CR-POPF.

Conclusion: RPD had several advantages compared with LPD, including shorter operative time and hospital stay, and lower open conversion rate. Postoperative complications including CR-POPF showed comparable results in two groups. Both LPD and RPD seemed to be feasible and safe approaches in experienced hands.
Full Text
https://onlinelibrary.wiley.com/doi/10.1002/jhbp.1078
DOI
10.1002/jhbp.1078
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Chang Moo(강창무) ORCID logo https://orcid.org/0000-0002-5382-4658
Choi, Munseok(최문석) ORCID logo https://orcid.org/0000-0002-9844-4747
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/188761
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