Postoperative complications and surgical outcomes of robotic versus laparoscopic Pancreaticoduodenectomy: A meta-analysis of propensity-score-matched studies

Gang Tang; Jie Zhang; Linyu Zhang; Lingying Xia; Rui Chen; Rongxing Zhou

doi:10.1097/JS9.0000000000002196

Postoperative complications and surgical outcomes of robotic versus laparoscopic Pancreaticoduodenectomy: A meta-analysis of propensity-score-matched studies

Int J Surg. 2024 Dec 24. doi: 10.1097/JS9.0000000000002196. Online ahead of print.

Authors

Gang Tang¹, Jie Zhang¹, Linyu Zhang², Lingying Xia^{1

3}, Rui Chen¹, Rongxing Zhou¹

Affiliations

¹ Division of Biliary Tract Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
² Center for Translational Medicine, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, China.
³ Analytical & Testing Center, Sichuan University, Chengdu, Sichuan, PR China.

PMID: 39715160
DOI: 10.1097/JS9.0000000000002196

Abstract

Background: Robotic pancreaticoduodenectomy (RPD) is used more commonly, but high-level evidence is still scarce. This meta-analysis aimed to compare the short-term outcomes between RPD and laparoscopic pancreaticoduodenectomy (LPD) using data collected from propensity score-matched (PSM) studies.

Materials and methods: We searched PubMed, Cochrane Library, Embase, and Web of Science databases for PSM studies comparing RPD and LPD. Risk ratios (RRs) and mean differences (MDs) with 95% confidence intervals (CIs) were calculated.

Results: Ten PSM studies were included, encompassing 8106 patients (RPD group: 3695 patients; LPD group: 4411 patients). Compared with LPD, RPD was associated with a lower conversion (RR, 0.56) and blood transfusion rates (RR, 0.49), and a higher number of harvested lymph nodes (MD, 2.15). There were no significant differences observed in 30-day readmission (RR, 1.02), 90-day mortality (RR, 1.01), overall morbidity (RR, 0.94), major complications (RR, 1.06), operative time (MD, - 8.00 mins), blood loss (MD, - 19.37 mL), reoperation (RR, 0.95), bile leak (RR, 0.93), chylous leak (RR, 1.40), postoperative pancreatic fistula (RR, 1.06), delayed gastric emptying (RR, 0.92), wound infection (RR, 1.12), length of stay (MD, - 0.32 days), and R0 resection (RR, 0.98) between the groups.

Conclusions: Although LPD and RPD had similar surgical outcomes, RPD had the perioperative advantage over LPD in decreasing conversion rates and blood transfusion rates and increasing the number of lymph nodes harvested. Further randomized controlled trials evaluating the potential advantages of RPD over LPD are warranted.