Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study

• DOI: 10.1016/j.surg.2024.02.015
• Publication Date: 2024-04-03T23:31:50Z
• Authors: Anouk M.L.H. Emmen; Maurice J.W. Zwart; Igor E. Khatkov; Ugo Boggi; Bas Groot Koerkamp; Olivier R. Busch; Olivier Saint-Marc; Safi Dokmak; I. Quintus Molenaar; Mathieu D’Hondt; Marco Ramera; Tobias Keck; Giovanni Ferrari; Misha D.P. Luyer; Luca Moraldi; Benedetto Ielpo; Uwe Wittel; Francois-Regis So...; Thilo Hackert; Daan Lips; Mehmet Fatih Can; Koop Bosscha; Regis Fara; Sebastiaan Festen; Susan van Dieren; Andrea Coratti; Ignace De Hingh; Michele Mazzola; Ulrich Wellner; Celine De Meyere; Hjalmar C. van Sa...; Béatrice Aussilhou; Abdallah Ibenkhayat; Roeland F. de Wilde; Emanuele F. Kauff...; Pavel Tyutyunnik; Marc G. Besselink; Mohammad Abu Hilal; Alberto Manzoni; Martina Guerra; Freek Daams; Geert Kazemier; Roman Izrailov; Mikhail Efanov; Niccolò Napoli; Michael Ginesini; Marie Cappelle; Roel Haen; Romain Quetel; Marco Pucci; Wouter. Derksen; Jeroen Hagendoorn; Fadhel Samir Ftér...; Milena Muzzolini; Franky Vansteenkiste; Louisa Bolm; Maike ten Winkel; Alessandro Giani; Pietro Calcagno
• Keywords: Male; 610; Middle Aged; Pancreaticoduodenectomy; Europe; Pancreatic Neoplasms; Postoperative Complications; Treatment Outcome; Robotic Surgical Procedures; 617; Humans; Female; Laparoscopy; Hospital Mortality; Propensity Score; Retrospective Studies; Aged

BackgroundThe use of robot-assisted and laparoscopic pancreatoduodenectomy is increasing, yet large adjusted analyses that can be generalized internationally are lacking. This study aimed to compare outcomes after in a pan-European cohort.MethodsAn international multicenter retrospective including patients from 50 centers 12 European countries (2009–2020). Propensity score matching was performed 1:1 ratio. The primary outcome major morbidity (Clavien–Dindo ≥III).ResultsAmong 2,082 undergoing minimally invasive pancreatoduodenectomy, 1,006 underwent 1,076 pancreatoduodenectomy. After 812 versus patients, the rates (31.9% vs 29.6%; P = .347) 30-day/in-hospital mortality (4.3% 4.6%; .904) did not differ significantly between respectively. Robot-assisted associated with lower conversion rate (6.7% 18.0%; < .001) higher lymph node retrieval (16 14; .003). Laparoscopic shorter operation time (446 minutes 400 minutes; .001), postoperative pancreatic fistula grade B/C (19.0% 11.7%; delayed gastric emptying (21.4% 7.4%; R0-resection (73.2% 84.4%; .001).ConclusionThis found no differences overall compared Further, fistula, emptying, wound infection, length stay, R0 resection than In contrast, number retrieved nodes as