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17.08.2017 | Original Article | Ausgabe 11/2017

Journal of Gastrointestinal Surgery 11/2017

Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 11/2017
Autoren:
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
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1007/​s11605-017-3543-6) contains supplementary material, which is available to authorized users.

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.

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ESM 1 (DOCX 14 kb)
11605_2017_3543_MOESM1_ESM.docx
Literatur
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