Robotic Pancreaticoduodenectomy Is Associated with Decreased Clinically Relevant Pancreatic Fistulas: a Propensity-Matched Analysis

Jianpeng Cai, Rajesh Ramanathan, Mazen S. Zenati, Amr Al Abbas, Melissa E. Hogg, Herbert J. Zeh, Amer H. Zureikat

Research output: Contribution to journalArticle

6 Scopus citations

Abstract

Background: Clinically relevant postoperative pancreatic fistula (CR-POPF) after pancreatoduodenectomy (PD) is a major complication that adversely affects recovery. The robotic approach may decrease the incidence of this complication. This propensity-matched analysis evaluates the impact of robotic PD (RPD) on CR-POPF. Methods: Patients undergoing PD after the learning curve at a high-volume academic medical center were reviewed. CR-POPF outcomes after open PD (OPD) and RPD were compared. Logistic regression and propensity score matching (PSM) were used to define the independent effect of RPD on CR-POPF. Results: Of 865 PDs performed over the study period, 405 (46.8%) were OPD and 460 (53.2%) were RPD. RPD was associated with a similar overall POPF rate, but a lower incidence of CR-POPF (6.7% vs. 15.8%, p < 0.001). On multivariate analysis, RPD was an independent predictor of lower CR-POPF (OR 0.278, p < 0.001). Following propensity matching, RPD continued to be protective against the occurrence of CR-POPF (coefficient = − 0.113, p = 0.001). Conclusions: This is the largest single-center PSM analysis to evaluate the impact of robotic approach on pancreatoduodenectomy and suggests that RPD can minimize the clinical impact of pancreatic leaks after PD.

Original languageEnglish (US)
Pages (from-to)1111-1118
Number of pages8
JournalJournal of Gastrointestinal Surgery
Volume24
Issue number5
DOIs
StatePublished - May 1 2020

Keywords

  • Minimally invasive
  • Pancreas fistula
  • Pancreatic leak
  • Pancreaticoduodenectomy
  • Whipple

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

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