SynthesisUpdates in surgery2021
Safety and efficacy of robot-assisted versus open pancreaticoduodenectomy: a meta-analysis of multiple worldwide centers.
Synthesis in Updates in surgery, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Comparative 30-day mortality and complications in robotic vs. open pancreaticoduodenectomy with portal-mesenteric vein resection: a systematic review and meta-analysis.Surgical endoscopy · 2025Pooled it
- Clinical effectiveness of robotic versus laparoscopic and open surgery: an overview of systematic reviews.BMJ open · 2024Pooled it
- Minimally Invasive Versus Open Pancreatoduodenectomy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Delayed gastric emptying after robot-assisted pancreatoduodenectomy: the Transatlantic Robot Pancreas Consortium (TROPANC).Surgical endoscopy · 2026Article
- Article
- Robotic Gastrointestinal Surgery Compared to Conventional Approaches: An Umbrella Review of Clinical and Economic Outcomes.Journal of clinical medicine · 2025Review
- Proposal for grading of intraoperative bleeding and the assessment of hemostasis quality during robot-assisted pancreatoduodenectomy.Surgical endoscopy · 2025Article
- Surgery-related factors for pancreatic fistula after pancreatectomy: an umbrella review.Hepatobiliary surgery and nutrition · 2025Review
- Reduced-port robotic pancreaticoduodenectomy with optimized surgical field deployment: early results of single-site plus-two ports method.Surgical endoscopy · 2024Article
- Rare tumours of the pancreas: monocentric study.Journal of cancer research and clinical oncology · 2024Article
- International consensus guidelines on robotic pancreatic surgery in 2023.Hepatobiliary surgery and nutrition · 2024Review
- Pancreatic Ductal Adenocarcinoma: Update of CT-Based Radiomics Applications in the Pre-Surgical Prediction of the Risk of Post-Operative Fistula, Resectability Status and Prognosis.Journal of clinical medicine · 2023Review
- Surgical management of pancreatic ductal adenocarcinoma: a narrative review.Translational gastroenterology and hepatology · 2023Review
- Robot-assisted pancreatoduodenectomy with the da Vinci Xi: can the costs of advanced technology be offset by clinical advantages? A case-matched cost analysis versus open approach.Surgical endoscopy · 2022Article
- EUS-guided gallbladder drainage in high-risk surgical patients with acute cholecystitis-procedure outcomes and evaluation of mortality predictors.Surgical endoscopy · 2022Article
- Choice of operative method for pancreaticojejunostomy and a multivariable study of pancreatic leakage in pancreaticoduodenectomy.World journal of gastrointestinal surgery · 2021Article
- Nomogram for Predicting the Prognoses of Patients With Pancreatic Head Cancer After Pancreaticoduodenectomy: A Population-Based Study on SEER Data.Frontiers in oncology · 2021Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
The objective of the study is to compare the safety and efficacy of robot-assisted pancreaticoduodenectomy (PD) with open PD. The PubMed, EMBASE and Cochrane Library databases were searched for the literature available from their respective inception dates up to May 2020 to find studies comparing robot-assisted pancreaticoduodenectomy (RPD) with open pancreaticoduodenectomy (OPD). The RevMan 5.3 statistical software was used for analysis to evaluate surgical outcome and oncology safety. The combination ratio (RR) and weighted mean difference (WMD) and their 95% confidence intervals (CIs) were calculated using fixed-effect or random effect models. 18 cohort studies from 16 medical centers were eligible with a total of 5795 patients including 1420 RPD group patients and 4375 OPD group patients. The RPD group fared better than the OPD group in terms of estimated blood loss (EBL) (WMD = - 175.65, 95% CI (- 251.85, - 99.44), P < 0.00001), wound infection rate (RR = 0.60, 95% CI (0.44, 0.81), P = 0.001), reoperation rate (RR = 0.61, 95% CI (0.41, 0.91), P = 0.02), hospital day (WMD = - 2.95, 95% CI (- 5.33, - 0.56), P = 0.02), intraoperative blood transfusion (RR = 0.56, 95% CI (0.42, 0.76), P = 0.0001), overall complications (RR = 0.78, 95% CI (0.64, 0.95), P = 0.01), and clinical postoperative pancreatic fistula (POPF) (RR = 0.54, 95% CI (0.41, 0.70), P < 0.0001). In terms of lymph node clearance (WMD = 0.48, 95% CI (- 2.05, 3.02), P = 0.71), R0 rate (RR = 1.05, 95% CI (1.00, 1.11), P = 0.05), postoperative pancreatic fistula (RR = 1, 95% CI (0.85, 1.19), P = 0.97), bile leakage (RR = 0.99, 95% CI (0.54, 1.83), P = 0.98), delayed gastric emptying (DGE) (RR = 0.79, 95% CI (0.60, 1.03), P = 0.08), 90-day mortality (RR = 0.82, 95% CI (0.62, 1.10), P = 0.19), and severe complications (RR = 0.98, 95% CI (0.71, 1.36), P = 0.91), and there were no significant differences between the two groups. Robotic surgery was inferior to open surgery in terms of operational time (WMD = 80.85, 95% CI (16.09, 145.61), P = 0.01). RPD is not inferior to OPD, and it is even more advantageous for EBL, wound infection rate, reoperation rate, hospital stay, intraoperative transfusion, overall complications and clinical POPF. However, these findings need to be further verified by high-quality randomized controlled trials.
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Registered trials
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.