SynthesisSurgical endoscopy2026
Does robotic pancreatoduodenectomy reduce the incidence of clinically relevant pancreatic fistula? A systematic review and meta-analysis.
Synthesis in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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.
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Who cites it
4 citing papers in PubMed.
- Horizontal hexagonal six-stitch pancreaticojejunostomy (HEXA-PJ): a simple and reproducible anastomotic technique.Surgery today · 2026Article
- 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
- Single-institution experience of 500 consecutive pancreatoduodenectomies: case-matched outcomes of the da Vinci Xi robotic versus open procedures.Surgical endoscopy · 2026Article
- Robotic portomesenteric vein reconstruction using self-fashioned bovine pericardial grafts during Da Vinci-assisted pancreatectomy: a case series with video demonstration.Surgical endoscopy · 2026Article
Corrections and comments
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPostoperative pancreatic fistula (POPF), particularly clinically relevant grades B and C (CR-POPF), remains a major source of morbidity following pancreatoduodenectomy (PD). Robotic pancreatoduodenectomy (RPD) has emerged as a minimally invasive alternative to open PD (OPD), potentially offering technical advantages that reduce complication rates. However, the true impact of RPD on CR-POPF remains unclear.
methodsA systematic review and meta-analysis were conducted in accordance with PRISMA guidelines, including studies published between January 2010 and June 2025. PubMed, Embase, Scopus, and Web of Science were queried for randomized trials, cohort studies, and propensity score-matched (PSM) analyses comparing RPD and OPD concerning CR-POPF as defined by the International Study Group on Pancreatic Surgery (ISGPS). Study quality was assessed using the Newcastle-Ottawa Scale, and the certainty of evidence was graded using the GRADE framework.
resultsThirty-two studies encompassing over 24 000 patients were included, of which approximately 5 000 underwent RPD and 19 600 underwent OPD. The pooled analysis showed a significantly lower incidence of CR-POPF in the RPD group (OR 0.60, 95% CI 0.51-0.67; p < 0.001), with moderate heterogeneity (I
conclusionsRPD is associated with a reduced incidence of CR-POPF when performed in experienced, high-volume centers. These findings support the selective implementation of RPD within structured training and quality-control programs. Further high-quality randomized trials are needed to validate these results and explore long-term outcomes.
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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.