ArticleAnnals of surgery2026
Cost-analysis of Implementing Robot-assisted Versus Open Pancreatoduodenectomy.
Article in Annals of surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis 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.
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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
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Pooled it
- Interest of the Robotic Approach for Pancreaticoduodenectomy in Elderly Patients in a Setting of Limited Robotic Platform Access: A Propensity Score-Matched Comparison with Open Surgery.Journal of clinical medicine · 2026Article
Corrections and comments
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Authors and funding
21 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo perform a cost analysis during the implementation of robot-assisted pancreatoduodenectomy (RPD) in a high-volume center.
backgroundMany high-volume centers are implementing RPD as an alternative to open pancreatoduodenectomy (OPD) but the persevering concerns about increased costs of RPD versus OPD have not been addressed by large studies.
methodsPost hoc cost analysis of consecutive RPD versus OPD in a singly high-volume center (January 2015-June 2024). The eligibility criteria for RPD (ie, no vascular contact, no chronic and necrotizing pancreatitis, and body mass index <35 kg/m 2 ) were used to select patients undergoing OPD to minimize selection bias. Primary outcomes were total hospital costs and total hospital stay. Sensitivity analyses excluded the first half of the RPD experience.
resultsOverall, 588 patients undergoing pancreatoduodenectomy were included (214 RPDs, 374 OPDs). Total hospital stay was shorter after RPD [10 days (6 to 17) vs 12 (8 to 21), P = 0.001]. Mean total hospital costs were €4804 higher for RPD (€27,307 vs €22,503, P = 0.010). Outcomes improved in the second half of the RPD experience (n = 107): total hospital stay [12 days (7 to 23) to 9 (6 to 15), P < 0.001], pancreatic fistula (48.6% to 31.8%, P = 0.012), delayed gastric emptying (33.6% to 15.0%, P = 0.001), and operative time [373 minutes (341 to 411) to 310 (272 to 352), P <0.001]. Consequently, costs per RPD procedure decreased by €11,058 (€32,836 to €21,778, P = 0.001). Costs in the second half of the OPD experience remained stable (€24,025 to €21,013, P = 0.210). Hence, total hospital costs for RPD and OPD became comparable in the second half (€21,778 vs €21,013, P = 0.644).
conclusionsImplementing RPD is associated with considerable additional costs compared with OPD. With growing experience, both the outcomes and cost-efficiency of RPD improve, with costs decreasing by approximately a third, leading to similar costs as OPD. Large-scale randomized trials will have to confirm these findings.
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