American Surgical Association Annual Meeting
Search Meeting Site Only
 
Main ASA Website
Current Meeting Home
Final Program
Past & Future Meetings

 

 

Back to 2016 Annual Meeting


A Multi-Institutional Comparison of Perioperative Outcomes of Robotic and Open Pancreaticoduodenectomy
David A Kooby*1, Lauren M Postlewait*1, Yuan Liu*2, Theresa W Gillespie*1, Sharon M Weber3, Daniel E Abbott*4, Shishir K Maithel*1, Melissa E Hogg*5, Mazen Zenati*5, Clifford S Cho*3, Ahmed Salem*3, Brent Xia*4, Jennifer Steve*5, Herbert J Zeh, III5, Amer H Zureikat*5
1Winship Cancer Institute, Emory University, Atlanta, GA;2Rollins School of Public Health, Emory University, Atlanta, GA;3University of Wisconsin School of Medicine and Public Health, Madison, WI;4University of Cincinnati Cancer Institute, Cincinnati, OH;5University of Pittsburgh Medical Center, Pittsburgh, PA

OBJECTIVE(S):
Limited data exist comparing robotic and open pancreaticoduodenectomy (PD). We performed a multicenter comparison of perioperative outcomes for these two approaches.
METHODS:
Clinical data for patients undergoing post-learning curve open and robotic PD (n=677) at 4 centers between 2011-2015 were assessed. Univariate and multivariate analyses were performed for associations between clinicopathologic and treatment factors with perioperative outcomes.
RESULTS:
166(24%) underwent robotic (3 conversions) and 511(76%) underwent open PD. Patients undergoing robotic procedures were older (65.41±2.0 vs 63.1±12.1yrs; p=0.04) and had lower incidence of ductal adenocarcinoma (37% vs 51%; p=0.002) than those who had open procedures; however, BMI (27.8±5.3 vs 26.6±5.2kg/m2) and Charlson Comorbidity Indices (2.6±1.5 vs 2.5±1.4) were similar between groups. On univariate analysis, operative blood loss (356±473 vs 323±320 mL), grade B/C fistula rates (9% vs 9%), Clavien grade≥3 complications (23% vs 21%), and 90-day mortality (2% vs 3%) were similar between groups (all p>0.05). Median length of stay, [8(7-12 IQR) vs 8(6-11) days, p=0.03], 90-day readmission rates (31% vs 21%; p=0.01) and operative time (393±78 vs 287±119 min; p<0.001) were higher in the robotic group on univariate analysis. On multivariate analysis, only operative time was significantly different between open and robotic PD cohorts (88 minutes longer in robotic cohort - multivariate adjusted; p<0.001).
CONCLUSIONS:
This represents the first multicenter comparison of open and robotic pancreaticoduodenectomy, demonstrating that, with the exception of longer operative times in the robotic cohort, perioperative outcomes appear similar between groups. Further studies investigating center-effect, cost, quality of life, and oncologic outcomes are needed.


Back to 2016 Annual Meeting


© 2022 American Surgical Association. All Rights Reserved. Privacy Policy.