SynthesisJournal of robotic surgery2026
Optimizing surgical strategy for pancreatoduodenectomy: a network meta-analysis and trial sequential analysis.
Synthesis in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPancreatoduodenectomy (PD) is performed using open, laparoscopic, or robotic techniques, but their relative perioperative outcomes remain unclear. This review compares these approaches using evidence from randomized trials.
methodsA systematic review and Bayesian network meta-analysis of RCTs comparing open, laparoscopic, and robotic PD was conducted following PRISMA-NMA guidelines. Data extraction, risk of bias (RoB2), and evidence certainty (GRADE) were performed by two independent reviewers. Primary outcomes included operative time, blood loss, length of stay, and complications. Bayesian models estimated pooled effects and treatment rankings, and Trial Sequential Analysis (TSA) assessed the robustness of evidence.
resultsDifferences between approaches were not statistically significant for most outcomes, and credible intervals were wide. Network meta-analysis of 9 studies suggested that laparoscopic PD ranked highest for reducing intraoperative blood loss (SUCRA 80.3), length of stay (SUCRA 75.5), surgical site infection (SUCRA 90.2), postoperative pancreatic fistula (SUCRA 86.7), and delayed gastric emptying (SUCRA 77.8). Open PD ranked highest for operative time (SUCRA 74.5) and preventing bile leakage (SUCRA 63.5), while robotic PD ranked highest for preventing 90-day mortality (SUCRA 89.6). TSA indicated conclusive evidence only for shorter operative time with open PD, while all other outcomes remained underpowered and uncertain, necessitating further trials.
conclusionLaparoscopic PD ranked highest for reducing intraoperative blood loss, shortening hospital stay, and minimizing certain postoperative complications, while open PD ranked highest for shorter operative time and reducing bile leakage. However, most differences between approaches were not statistically significant, and credible intervals were wide, indicating uncertainty. Further high-quality, adequately powered trials are needed to confirm these findings and guide optimal selection of the surgical approach.
Indexed as
Identifiers
41699337What OpenQuestion holds
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.