Comparison of Short‐Term Outcomes Between Robotic‐Assisted and Open Pancreatoduodenectomy: A Retrospective Cohort Study With Inverse Probability of Treatment Weighting (IPTW) Analysis

摘要

BACKGROUND: The advantages of robotic-assisted pancreatoduodenectomy (RPD) in comparison with open pancreatoduodenectomy (OPD) have not been well-established. We aimed to compare their short-term outcomes by inverse probability of treatment weighting (IPTW) analysis. METHODS: Patients who underwent RPD/OPD at our hospital were recruited. Stabilised IPTW were performed to adjust observed covariates. Short-term outcomes were compared. RESULTS: After IPTW, the effective sample comprised 807 patients (199 RPD, 608 OPD) with balanced clinicopathological characteristics. RPD had a longer operation time, fewer intraoperative blood loss (IBL), and lower blood transfusion rate than OPD. RPD was associated with a lower incidence of clinically relevant postoperative pancreatic fistula and reoperation but did not reach statistical significance. In pancreatic adenocarcinoma, RPD had a significantly higher number of lymph nodes examined. There were no significant differences in postoperative morbidities and length-of-stay. CONCLUSIONS: RPD was associated with fewer IBL and transfusion rates than OPD. RPD can be considered feasible and safe.