Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis

Ibrahim Nassour, Sam C. Wang, Matthew R. Porembka, Adam C. Yopp, Michael A. Choti, Mathew M. Augustine, Patricio M. Polanco, John C. Mansour, Rebecca M. Minter

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy. Methods: Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014–2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications. Results: We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55%) were performed laparoscopically and 193 (45%) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09), vascular resection (OR, 2.10; 95% CI, 1.23–3.58), and longer operative time (OR, 1.002; 95% CI, 1.001–1.004). Conclusions: Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Aug 17 2017

Fingerprint

Pancreaticoduodenectomy
Robotics
Odds Ratio
Confidence Intervals
Blood Vessels
Logistic Models
Operative Time
Quality Improvement
Lung Diseases
Pancreas
Body Mass Index
Radiotherapy
Safety

Keywords

  • Laparoscopic
  • Minimally invasive
  • NSQIP
  • Pancreaticoduodenectomy
  • Robotic

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

@article{738d4224b63646ad98f272964dcfde6c,
title = "Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis",
abstract = "Background: An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy. Methods: Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014–2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications. Results: We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55{\%}) were performed laparoscopically and 193 (45{\%}) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95{\%} confidence interval [CI], 1.02–1.09), vascular resection (OR, 2.10; 95{\%} CI, 1.23–3.58), and longer operative time (OR, 1.002; 95{\%} CI, 1.001–1.004). Conclusions: Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.",
keywords = "Laparoscopic, Minimally invasive, NSQIP, Pancreaticoduodenectomy, Robotic",
author = "Ibrahim Nassour and Wang, {Sam C.} and Porembka, {Matthew R.} and Yopp, {Adam C.} and Choti, {Michael A.} and Augustine, {Mathew M.} and Polanco, {Patricio M.} and Mansour, {John C.} and Minter, {Rebecca M.}",
year = "2017",
month = "8",
day = "17",
doi = "10.1007/s11605-017-3543-6",
language = "English (US)",
pages = "1--9",
journal = "Journal of Gastrointestinal Surgery",
issn = "1091-255X",
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TY - JOUR

T1 - Robotic Versus Laparoscopic Pancreaticoduodenectomy

T2 - a NSQIP Analysis

AU - Nassour, Ibrahim

AU - Wang, Sam C.

AU - Porembka, Matthew R.

AU - Yopp, Adam C.

AU - Choti, Michael A.

AU - Augustine, Mathew M.

AU - Polanco, Patricio M.

AU - Mansour, John C.

AU - Minter, Rebecca M.

PY - 2017/8/17

Y1 - 2017/8/17

N2 - Background: An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy. Methods: Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014–2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications. Results: We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55%) were performed laparoscopically and 193 (45%) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09), vascular resection (OR, 2.10; 95% CI, 1.23–3.58), and longer operative time (OR, 1.002; 95% CI, 1.001–1.004). Conclusions: Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.

AB - Background: An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy. Methods: Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014–2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications. Results: We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55%) were performed laparoscopically and 193 (45%) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02–1.09), vascular resection (OR, 2.10; 95% CI, 1.23–3.58), and longer operative time (OR, 1.002; 95% CI, 1.001–1.004). Conclusions: Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.

KW - Laparoscopic

KW - Minimally invasive

KW - NSQIP

KW - Pancreaticoduodenectomy

KW - Robotic

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U2 - 10.1007/s11605-017-3543-6

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JO - Journal of Gastrointestinal Surgery

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