ArticleSurgical endoscopy2019
The learning curve for a surgeon in robot-assisted laparoscopic pancreaticoduodenectomy: a retrospective study in a high-volume pancreatic center.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 9 of them syntheses that pooled it.
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Who cites it
76 citing papers in PubMed, 9 syntheses or guidelines pooled it, 147 citations in OpenAlex.
- The learning curve of robotic pancreatoduodenectomy: a systematic review of learning curve assessment methodologies, proficiency thresholds, training pathways and clinical outcomes.Journal of robotic surgery · 2026Pooled it
- Robotic versus laparoscopic pancreatoduodenectomy across the learning curve: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2026Pooled it
- Systematic review and meta-analysis of the learning curve and mentoring in robotic pancreatectomy: transitioning from novice to expert robotic surgeon.Journal of robotic surgery · 2025Pooled it
- Minimal Invasive Pancreatoduodenectomy: A Comprehensive Systematic Review and Metanalysis of Randomized Controlled Clinical Trials.Annals of surgical oncology · 2025Pooled it
- Comparing Operative Outcomes and Resection Quality in Robotic vs Open Pancreaticoduodenectomy: A Meta-analysis of 54,000 Patients.Journal of gastrointestinal cancer · 2025Pooled it
- Robotic versus open total pancreatectomy: a systematic review and meta-analysis.Journal of robotic surgery · 2023Pooled it
- Learning curves in minimally invasive pancreatic surgery: a systematic review.Langenbeck's archives of surgery · 2022Pooled it
- Laparoscopic vs. Open Pancreaticoduodenectomy After Learning Curve: A Systematic Review and Meta-Analysis of Single-Center Studies.Frontiers in surgery · 2021Pooled it
- Pooled it
- Increased Mortality with Surgeon Adoption of Robotic Pancreaticoduodenectomy: A National EHR Study of Outcomes.Annals of surgical oncology · 2026Article
- Independent risk factors for clinically relevant postoperative pancreatic fistula after robotic pancreatoduodenectomy: the protective role of the modified Blumgart pancreatojejunostomy in a single surgeon retrospective cohort of 220 cases.Hepatobiliary surgery and nutrition · 2026Article
- The Progress of Pancreatectomy for Pancreatic Cancer Treatment-Lessons Learned and Future Challenges.Cancers · 2026Review
- Revelations of pancreatic cancer treated by high-intensity focused ultrasound.Discover oncology · 2026Article
- The Hidden Cost of Precision: Financial, Training, and Environmental Trade-Offs in Robotic HPB Surgery.Journal of robotic surgery · 2026Review
- Comparison of perioperative outcomes between robotic and laparoscopic pancreaticoduodenectomy: a single-center propensity score matching analysis.BMC surgery · 2026Article
- Association of computed tomography-derived body composition with surgical and oncologic outcomes in periampullary adenocarcinoma.Surgical endoscopy · 2026Article
- Influence of Surgical Technique and Surgical Skill on Outcomes of Cleft Palate Repair.Plastic and reconstructive surgery · 2026Observational
- Non-inferiority of robotic versus open pancreatoduodenectomy - a systematic review and meta-analysis of prospective non-randomized and randomized trials.EClinicalMedicine · 2026Article
- Barbed sutures for hepaticojejunostomy in robotic pancreatoduodenectomy: a case-matched analysis.Surgical endoscopy · 2026Article
- Safety and learning curve of robotic pancreatoduodenectomy with limited robotic platform access: a propensity score-matched comparison with open surgery in a high-volume center.Hepatobiliary surgery and nutrition · 2025Article
16 more citing papers are in PubMed but not listed here.
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreaticoduodenectomy (PD) is one of the most technically difficult abdominal operations. Recent advances have allowed surgeons to attempt PD using minimally invasive surgery techniques. This retrospective study aimed to analyze the learning curve of a single surgeon who had carried out his first 100 robot-assisted laparoscopic pancreaticoduodenectomy (RPD) in a high-volume pancreatic center.
methodsThe data on consecutive patients who underwent RPD for malignant or benign pathologies were prospectively collected and retrospectively analyzed. The data included the demographic data, operative time, estimated blood loss, postoperative length of hospital stay, morbidity rate, mortality rate, and final pathological results. The cumulative sum (CUSUM) analysis was used to identify the inflexion points which corresponded to the learning curve.
resultsBetween 2012 and 2016, 100 patients underwent RPD by a single surgeon. From the CUSUM operation time (CUSUM OT) learning curve, two distinct phases of the learning process were identified (early 40 patients and late 60 patients). The operation time (mean, 418 min vs. 317 min), hospital stay (mean, 22 days vs. 15 days), and estimated blood loss (mean, 227 ml vs. 134 ml) were significantly lower after the first 40 patients (P < 0.05). The pancreatic fistula, postoperative hemorrhage, delayed gastric emptying, and reoperation rates also decreased in the late 60 patients group (P < 0.05). Non-significant reductions were observed in the incidences of major (Clavien-Dindo Grade II or higher) morbidity, postoperative death, bile leakage, gastric fistula, wound infection, and open conversion.
conclusionsRPD was technically feasible and safe in selected patients. The learning curve was completed after 40 RPD. Further studies are required to confirm the long-term oncological outcomes of RPD.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.