Robotic-assisted versus open pancreaticoduodenectomy: the results of a case-matched comparison

Robotic-assisted pancreaticoduodenectomy (RPD) is progressively gaining momentum. It seems to provide some potential advantages over open approach. Unfortunately, only few studies investigated the impact of RPD on the oncologic outcomes. We performed a 1:1 case-matched comparison between two groups of 35 patients affected by a malignant tumor who underwent RPD and open (OPD) pancreaticoduodenectomy from August 2014 to April 2016. Operative time was longer in the RPD group compared to OPD (355 vs 262 min, p = 0.023), whereas median blood loss (235 vs 575 ml, p = 0.016) and length of hospitalization (6.5 vs 8.9 days, p = 0.041) were lower for RPD. A significant reduction of overall postoperative morbidity rate was found in the RPD group compared to the OPD group (31.4% vs 48.6% p = 0.034). No statistically significant difference was found between the two groups in terms of overall pancreatic fistula rate, R0 resection rate, and number of harvested lymph nodes. The overall and disease-free survival at 1 and 3 years were similar. RPD is a safe and effective technique. It reduces the estimated blood loss, the length hospital of stay and the rate of complications after pancreaticoduodenectomy, while preserving a good oncologic adequacy.