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Surgical Endoscopy
Published in: Surgical Endoscopy 9/2017

01-09-2017 | Review

Totally laparoscopic or robot-assisted pancreaticoduodenectomy versus open surgery for periampullary neoplasms: separate systematic reviews and meta-analyses

Authors: Sang Hyun Shin, Ye-Jee Kim, Ki Byung Song, Seong-Ryong Kim, Dae Wook Hwang, Jae Hoon Lee, Kwang-Min Park, Young-Joo Lee, Eunsung Jun, Song Cheol Kim

Published in: Surgical Endoscopy | Issue 9/2017

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Abstract

Objective

To compare perioperative and oncologic outcomes of pure (totally) laparoscopic pancreaticoduodenectomy (TLPD) or robot-assisted pancreaticoduodenectomy (RAPD) with those of conventional open pancreaticoduodenectomy (OPD).

Methods

A systematic literature search was performed using PubMed, EMBASE, and Cochrane library databases. Studies comparing TLPD with OPD and RAPD with OPD were included; only original studies reporting more than 10 cases for each technique were included. Studies were combined using a random-effects model to report heterogeneous data, or a fixed-effects model was applied.

Results

TLPD involved longer operative time (weighted mean difference [WMD]: 116.85 min; 95% confidence interval [CI] 54.53–179.17) and significantly shorter postoperative hospital stay (WMD: −3.68 days; 95% CI −4.65 to −2.71). Overall morbidity and postoperative pancreatic fistula were not significantly different between TLPD and OPD. RAPD was associated with a longer operative time, less intraoperative blood loss, and shorter hospital stay. Oncologic outcomes were not significantly different among the procedure types.

Conclusions

Compared to OPD, TLPD and RAPD were feasible and oncologically safe procedures. However, there are no prospective studies, and the majority of the studies on TLPD and RAPD have remained in the early training phase. In addition to randomized controlled trials or prospective studies, new data from the late training phase of learning experiences should also be analyzed.
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Metadata
Title
Totally laparoscopic or robot-assisted pancreaticoduodenectomy versus open surgery for periampullary neoplasms: separate systematic reviews and meta-analyses
Authors
Sang Hyun Shin
Ye-Jee Kim
Ki Byung Song
Seong-Ryong Kim
Dae Wook Hwang
Jae Hoon Lee
Kwang-Min Park
Young-Joo Lee
Eunsung Jun
Song Cheol Kim
Publication date
01-09-2017
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 9/2017
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5395-7

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