ArticleSurgical endoscopy2024
Comparing oncologic and surgical outcomes of robotic and laparoscopic pancreatoduodenectomy in patients with pancreatic cancer: a propensity-matched analysis.
Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 8 of them syntheses that pooled it.
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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.
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Who cites it
21 citing papers in PubMed, 8 syntheses or guidelines pooled it, 29 citations in OpenAlex.
- Pancreatic surgery and length of hospital stay: meta-analysis of randomized clinical trials.BJS open · 2026Pooled it
- Robotic versus laparoscopic pancreatoduodenectomy across the learning curve: a systematic review and meta-analysis.Langenbeck's archives of surgery · 2026Pooled it
- Minimally invasive versus open pancreaticoduodenectomy for periampullary tumors: a systematic review and meta-analysis of randomized controlled trials.Surgical endoscopy · 2025Pooled it
- Robotic vs laparoscopic approaches of pancreatic resection: a systematic review and meta-analysis.Journal of robotic surgery · 2025Pooled it
- Comparing the operative, oncological, post-operative outcomes and complications of robotic and laparoscopic pancreaticoduodenectomy for the treatment of pancreatic and periampullary cancers: a systematic review and meta-analysis with subgroup analysis.Journal of robotic surgery · 2025Pooled it
- Perioperative outcomes of robotic vs laparoscopic pancreatoduodenectomy: a meta-analysis and trial sequential analysis.Surgical endoscopy · 2025Pooled it
- Robotic pancreatoduodenectomy provides better short-term outcomes as compared to its laparoscopic counterpart: a meta-analysis.Frontiers in oncology · 2025Pooled it
- Robotic versus laparoscopic pancreaticoduodenectomy for pancreatic and periampullary tumors: a meta-analysis.Frontiers in oncology · 2024Pooled it
- Adjusted trend analysis in the adoption and outcomes of minimally invasive pancreaticoduodenectomy approaches: over a decade of contemporary U.S. data.Surgical endoscopy · 2026Article
- Robotic Versus Laparoscopic Pancreaticoduodenectomy: A Review of Contemporary Evidence on Surgical Outcomes and Learning Curve.The international journal of medical robotics + computer assisted surgery : MRCAS · 2026Review
- Optimal Timing of Adjuvant Therapy in Patients with Poorly Differentiated Pancreatic Adenocarcinoma.Annals of surgical oncology · 2026Article
- Recent advances in hydrogel-based delivery systems for the treatment of pancreatic cancer.Materials today. Bio · 2025Review
- Robotic Pancreaticoduodenectomy: Current Evidence and Future Perspectives.Journal of clinical medicine · 2025Review
- Textbook outcome following surgery for pancreatic neuroendocrine tumours: retrospective study.BJS open · 2025Article
- Laparoscopic versus robotic pancreaticoduodenectomy for distal cholangiocarcinoma after learning curves of surgeons: a multicenter propensity score-matched study.Hepatobiliary surgery and nutrition · 2025Article
- Sequence of Chemotherapy May Not Impact Survival After Resection of Pancreatic Tail Adenocarcinoma.Journal of surgical oncology · 2025Article
- Review
- ASO Author Reflections: The Advantages of Robotic Pancreaticoduodenectomy for Pancreatic Cancer.Annals of surgical oncology · 2024Article
- Consensus, debate, and prospective on pancreatic cancer treatments.Journal of hematology & oncology · 2024Review
- Effects of Minimally Invasive Versus Open Pancreatoduodenectomy on Short-Term Surgical Outcomes and Postoperative Nutritional and Immunological Statuses: A Single-Institution Propensity Score-Matched Study.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2024Article
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMinimally invasive Pancreatoduodenectomy (MIPD), or the Whipple procedure, is increasingly utilized. No study has compared laparoscopic (LPD) and robotic (RPD) approaches, and the impact of the learning curve on oncologic, technical, and post-operative outcomes remains relatively understudied.
methodsThe National Cancer Database was queried for patients undergoing LPD or RPD from 2010 to 2020 with a diagnosis of pancreatic cancer. Outcomes were compared between approaches using propensity-score matching (PSM); the impact of annual center-level volume of MIPD was also assessed by dividing volume into quartiles.
resultsA total of 3,342 patients were included. Most (n = 2,716, 81.3%) underwent LPD versus RPD (n = 626, 18.7%). There was a high rate (20.2%, n = 719) of positive margins. Mean length-of-stay (LOS) was 10.4 ± 8.9 days. Thirty-day mortality was 2.8% (n = 92) and ninety-day mortality was 5.7% (n = 189). PSM matched 625 pairs of patients receiving LPD or RPD. After PSM, there was no differences between groups based on age, sex, race, CCI, T-stage, neoadjuvant chemo/radiotherapy, or type of PD. After PSM, there was a higher rate of conversion to open (HR = 0.68, 95%CI = 0.50-0.92)., but there was no difference in LOS (HR = 1.00, 95%CI = 0.92-1.11), 30-day readmission (HR = 1.08, 95% CI = 0.68-1.71), 30-day (HR = 0.78, 95% CI = 0.39-1.56) or 90-day mortality (HR = 0.70, 95% CI = 0.42-1.16), ability to receive adjuvant therapy (HR = 1.15, 95% CI = 0.92-1.44), nodal harvest (HR = 1.01, 95%CI = 0.94-1.09) or positive margins (HR = 1.19, 95% CI = 0.89-1.59). Centers in lower quartiles of annual volume of MIPD demonstrated reduced nodal harvest (p = 0.005) and a higher rate of conversion to open (p = 0.038). Higher-volume centers had a shorter LOS (p = 0.012), higher rate of initiation of adjuvant therapy (p = 0.042), and, most strikingly, a reduction in 90-day mortality (p = 0.033).
conclusionLPD and RPD have similar surgical and oncologic outcomes, with a lower rate of conversion to open in the robotic cohort. The robotic technique does not appear to eliminate the "learning curve", with higher volume centers demonstrating improved outcomes, especially seen at minimum annual volume of 5 cases.
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