Evidence map›Paper›PMID 40355734›Full record

ArticleSurgical endoscopy2025

Reduced pancreatic fistula rates and comprehensive cost analysis of robotic versus open pancreaticoduodenectomy.

Taiga Wakabayashi, Federico Gaudenzi, Yusuke Nie, Kohei Mishima, Yoshiki Fujiyama, Kazuharu Igarashi, Yu Teshigahara, Sho Mineta, Emre Bozkurt, Go Wakabayashi

Abstract readComparative Study
In one paragraph

Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
  3. Article
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Taiga Wakabayashi *Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan. taiga.wakabayashi@me.com.ORCID http://orcid.org/0000-0002-5074-0205
Federico Gaudenzi *Center for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Yusuke NieCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Kohei MishimaCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Yoshiki FujiyamaCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Kazuharu IgarashiCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Yu TeshigaharaCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.
Sho MinetaDepartment of Surgery, Chiba Tokushukai Hospital, Chiba, Japan.
Emre BozkurtDepartment of General Surgery, Koç University School of Medicine, Istanbul, Turkey.
Go WakabayashiCenter for Advanced Treatment of Hepatobiliary and Pancreatic Diseases, Ageo Central General Hospital, 1-10-10 Kashiwaza, Ageo, Saitama, 362-8588, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic pancreaticoduodenectomy (RPD) has emerged as a promising surgical approach for the treatment of periampullary neoplasms, offering the potential benefits of minimally invasive surgery. However, the impact of RPD on clinically relevant pancreatic fistula (CR-PF) rates and overall costs compared to open pancreaticoduodenectomy (OPD) remains unclear, limiting its widespread adoption.

methodsThis retrospective cohort study was conducted at a high-volume Japanese referral center from 2017 to 2023. A total of 193 patients diagnosed with periampullary neoplasms underwent either RPD (n = 81) or OPD (n = 112). To account for potential selection bias, propensity score matching (PSM) was used to balance patient demographics and clinical characteristics, resulting in two well-matched groups of 60 patients each. Perioperative outcomes, CR-PF rates, and a comprehensive cost analysis were evaluated.

resultsRPD resulted in a significantly lower rate of CR-PF (10%) compared to OPD (33.3%) (p = 0.003). Additionally, patients who underwent RPD experienced shorter hospital stays (15 days) compared to those in the OPD group (22.5 days) (p < 0.001). Despite longer operative times for RPD (633 vs. 395 min; p < 0.001), total hospital costs were comparable between the two groups. The higher operative costs associated with RPD were offset by reduced postoperative complications and shorter hospitalization.

conclusionsRPD offers significant clinical advantages, including lower CR-PF rates and reduced hospital stays, without increasing overall hospital costs compared to OPD. These findings support the feasibility and potential benefits of adopting RPD for the management of periampullary neoplasms in clinical practice.

Indexed as

Common Bile Duct NeoplasmsPancreatic FistulaPancreatic NeoplasmsPancreaticoduodenectomyPostoperative ComplicationsRobotic Surgical ProceduresAgedCosts and Cost AnalysisFemaleHumansLength of StayMaleMiddle AgedPropensity ScoreRetrospective StudiesCost analysisOpen pancreaticoduodenectomyPancreatic fistulaPeriampullary neoplasmsPostoperative outcomesRobotic pancreaticoduodenectomy

Identifiers

PMID40355734
PMCPMC12116723

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LicenceCC BY-NC-ND
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Registered trials

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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.