ArticleSurgery today2026
Robotic distal pancreatectomy has a lower incidence than open surgery of clinically relevant pancreatic fistula: a propensity score-matched analysis with emphasis on inflammation and microbial contamination.
Article in Surgery today, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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13 authors.
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Abstract
purposeRobotic distal pancreatectomy (RDP) is being adopted increasingly, but its impact on clinically relevant postoperative pancreatic fistula (CR-POPF) compared with that of open distal pancreatectomy (ODP) remains unclear. We compared the incidences of CR-POPF after RDP vs. ODP, focusing on postoperative inflammation and drain bacterial contamination.
methodsThe subjects of this retrospective analysis were 125 patients who underwent stapler-based distal pancreatectomy at a single center between 2013 and 2025 (RDP, n = 50; ODP, n = 75). Propensity score matching yielded 32 matched patients in each group. Outcomes included CR-POPF, postoperative C-reactive protein, drain amylase levels, and drain fluid cultures on postoperative days (PODs) 1 and 3. Multivariable analysis was performed to identify the factors associated with CR-POPF.
resultsAfter matching, it was evident that the RDP group had less blood loss (median 95 vs. 573 mL, p < 0.001) and fewer transfusions (3% vs. 19%, p = 0.045). Positive POD-3 drain cultures were less frequent after RDP (6% vs. 25%, p = 0.039). CR-POPF occurred less often after RDP than ODP (6% vs. 41%, p = 0.001). Exploratory analysis revealed that RDP was associated with a lower incidence of CR-POPF, whereas positive POD 3 drain culture was associated with increased risk.
conclusionsRDP was associated with a lower incidence of CR-POPF, which may be related to differences in postoperative inflammation and bacterial contamination.
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