Assessment of learning curve and oncologic feasibility of robotic pancreaticoduodenectomy: A propensity score‐based comparison with open approach. (6th November 2020)

• Record Type: Journal Article
• Authors: Kim, Hyeyeon; Park, Seo Young; Park, Yejong; Kwon, Jaewoo; Lee, Woohyung; Song, Ki Byung; Hwang, Dae Wook; Kim, Song Cheol; Lee, Jae Hoon
• Is Part Of: Journal of hepato-biliary-pancreatic sciences. Volume 29:Number 6(2022)
• Page Start: 649
• Page End: 658
• Publication Date: 2020-11-06
• Subjects: pancreaticoduodenectomy -- robot -- learning curve -- propensity score matching; Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 617.556
• DOI: 10.1002/jhbp.837
• Languages: English
• ISSNs: 1868-6974

Abstract

Abstract: Background: Though robotic pancreaticoduodenectomy(R‐PD) is gradually adopted, learning curve and its feasibility is still controversial. We analyzed our first 70 R‐PD cases, comparing surgical outcomes and feasibility to those of open pancreaticoduodenectomy (O‐PD). Methods: Medical records of 70 patients of R‐PD and 269 patients of O‐PD between 2015 and 2019 were retrospectively analyzed. Cumulative sum analysis was used to determine learning curve. Surgical outcomes were compared between early(1‐35) and late cases(36‐70). Additional analyses with O‐PD using propensity score‐matching were done. Results: Learning curve of R‐PD completed after 30 cases. Shorter operative time, lower estimated blood loss, and shorter length of stay were noted in later cases. Complication rate tended to decrease over time. In comparison with O‐PD after matching, R‐PD showed longer operation time(414.5 minutes vs 244.7 minutes; P < .001), with no differences in estimated blood loss, or length of stay. While overall complication rate was higher in R‐PD(45.5% vs 21.8%; P = .010), no statistically significant difference was observed in major complication rates(23.6% vs 10.9%; P = .084). R0 rate was equivalent. Conclusion: Surgical performance of R‐PD improved over time. Learning curve of R‐PD completed after 30 cases. R‐PD is a promising modality, based on comparison of perioperative and oncologic feasibilities to those of O‐PD. Abstract : Highlight Kim and colleagues analyzed the first 70 cases of robotic pancreaticoduodenectomy performed by a single surgeon at a single institution. The learning curve, analyzed on the basis of operative time, was completed after 30 cases. Perioperative outcomes and oncologic feasibility of robotic pancreaticoduodenectomy were comparable to those of open pancreaticoduodenectomy.