Evidence map›Paper›PMID 42321498›Full record

SynthesisLangenbeck's archives of surgery2026

Robotic versus laparoscopic pancreatoduodenectomy across the learning curve: a systematic review and meta-analysis.

Ahmed Abdelsamad, Khaled Mohamed, Youssef Badie, Zainab Hussein, Mennatullah Mohsen, Osama Selim, Omar Mohamed, Mohammed Khaled Mohammed, Zeyad M Wesh, Felix Nickel and 2 more

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Langenbeck's archives of 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.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

Ahmed AbdelsamadDepartment of Surgery II, University of Witten/Herdecke, 58455, Witten, Germany. ahmed6361410@gmail.com.ORCID http://orcid.org/0000-0002-5451-4504
Khaled MohamedGeneral surgery resident at Cairo University Hospitals, Cairo University, Cairo, Egypt.ORCID http://orcid.org/0000-0002-0139-2873
Youssef BadieFaculty of Medicine, Alexandria University, Alexandria, Egypt.ORCID http://orcid.org/0009-0004-2787-9534
Zainab HusseinFaculty of Medicine, Minia University, Minia, Egypt.ORCID http://orcid.org/0009-0002-9667-8504
Mennatullah MohsenMedical intern at faculty of Medicine, Al-Azhar University, Cairo for girls, Egypt.ORCID http://orcid.org/0009-0000-4823-5317
Osama SelimFaculty of Medicine, Cairo University, Giza, Egypt.
Omar MohamedMedical intern at faculty of Medicine, Ain Shams University, Cairo, Egypt.ORCID http://orcid.org/0009-0003-5395-1766
Mohammed Khaled MohammedFaculty of Medicine, Cairo University, Giza, Egypt.ORCID http://orcid.org/0009-0003-3585-4874
Zeyad M WeshFaculty of Medicine, Alexandria University, Alexandria, Egypt.ORCID http://orcid.org/0009-0008-8748-6299
Felix NickelDepartment of Surgery, University of Hamburg-Eppendorf, Hamburg, Germany.
Sascha VaghiriDepartment of Surgery (A), Heinrich-Heine-University, Medical Faculty and University, Hospital Duesseldorf, Moorenstr. 5, Duesseldorf, 40225, Germany.
Florian GebauerDepartment of Surgery II, University of Witten/Herdecke, 58455, Witten, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMinimally invasive pancreatoduodenectomy (MIPD) has a substantial learning curve. This systematic review and meta-analysis evaluated learning-phase effects in robotic (RPD) and laparoscopic pancreatoduodenectomy (LPD).

methodsThe protocol was registered in PROSPERO (CRD420261283406). PubMed, Scopus, and Web of Science were searched through June 1, 2026. Studies reporting early-versus-late learning-phase outcomes or phase-specific RPD-versus-LPD comparisons were included. Random-effects models were used, and the certainty of evidence was assessed using GRADE.

resultsTwenty-five studies were included qualitatively and 20 quantitatively, comprising 4,764 patients. The median case volume required to overcome the learning curve was similar for RPD and LPD (31.5 vs. 35 cases; p = 0.56). Late-phase MIPD was associated with significantly shorter operative time, lower estimated blood loss, lower conversion rate, shorter length of stay, and reduced rates of POPF, bile leak, and delayed gastric emptying. During the early phase, RPD had a longer operative time but a shorter length of stay and a lower CR-POPF than LPD. In the late phase, RPD showed lower conversion, while most other outcomes were comparable.

conclusionBoth RPD and LPD improve with experience. RPD may offer selected learning-phase advantages, but current evidence does not support broad superiority over LPD.

Indexed as

LaparoscopyLearning CurvePancreaticoduodenectomyRobotic Surgical ProceduresHumansLength of StayOperative TimeLaparoscopic pancreatoduodenectomyLearning curveRobotic pancreatoduodenectomyWhipple operation

Identifiers

PMID42321498
PMCPMC13287129

What OpenQuestion holds

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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.