ArticleThe British journal of surgery2025
Nationwide outcomes of 1000 robotic pancreatoduodenectomies across the four phases of the learning curve.
Article in The British journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Conversion to open surgery during robotic pancreatoduodenectomy in surgical high-risk groups: patterns, risk factors, and outcomes in elderly and/or obese patients.Surgical endoscopy · 2026Observational
- Development and frontier trends of pancreaticojejunostomy over the past 26 years: bibliometric and visual analysis.Gland surgery · 2026Article
- Early clinical impact of mesenteric Kocherization in robotic pancreaticoduodenectomy: a propensity score-matched comparative study.Surgical endoscopy · 2026Article
- The breaking point in robotic pancreaticoduodenectomy: factors influencing conversion thresholds and early postoperative outcomes in a tertiary referral center.Surgical endoscopy · 2026Article
- A comparative analysis of safety and short-term efficacy between open and laparoscopic pancreaticoduodenectomy utilizing different drainage techniques.Frontiers in oncology · 2026Article
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Authors and funding
26 authors.
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Abstract
backgroundRobotic pancreatoduodenectomy (RPD) is increasingly being implemented to enhance patient recovery, but it is unclear what happens to patient outcomes after the initial learning curve. The aim of this study was to evaluate the first 1000 consecutive RPD performed in the Netherlands.
methodsA nationwide analysis of patients who underwent RPD in 13 centres (March 2016-August 2023) from the Dutch Pancreatic Cancer Audit was performed. Patients were grouped based on published learning curve cut-offs (phases 1-4): 1-15, 16-62, 63-84, and >84 RPD per centre respectively. Outcomes were compared between the four learning curve phases. Ideal Outcome rates were used to compare outcomes between centres.
resultsOverall, 1000 patients after RPD were included. The conversion rate was 10.1%, the rate of Clavien-Dindo complications of grade ≥III was 41.3%, the rate of postoperative pancreatic fistula of grade B/C was 24.4%, and the rate of in-hospital/30-day mortality was 3.9%. Of the patients, 71.1% had a high updated alternative fistula risk score. Improvements between the phases were found for five outcomes: median operating time (420, 360, 349, and 369 min respectively; P < 0.001), conversion rate (21.7%, 10.0%, 2.8%, and 7.5% respectively; P < 0.001), rate of delayed gastric emptying (DGE) of grade B/C (32.3%, 22.6%, 15.4%, and 20.2% respectively; P = 0.003), reoperation rate (9.9%, 11.3%, 9.8%, and 4.9% respectively; P = 0.026), and median duration of hospital stay (12, 11, 10, and 10 days respectively; P = 0.035). The rate of Clavien-Dindo complications of grade ≥III and the rate of in-hospital/30-day mortality remained stable. The Ideal Outcome rate (mean 47%) did not differ between centres.
conclusionAcross four learning curve phases in a nationwide cohort, improvements were observed for operating time, conversion rate, rate of DGE of grade B/C, reoperation rate, and duration of hospital stay.
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