Evidence map›Paper›PMID 42560533›Full record

ReviewSurgery today2026

Evaluating the value of robotic versus open pancreaticoduodenectomy: improved clinical outcomes without compromising hospital revenue per admission.

Yusuke Seki, Yoshikuni Kawaguchi, Takeshi Kano, Kyoji Ito, Satoru Abe, Yujiro Nishioka, Akihiko Ichida, Takeshi Takamoto, Nobuhisa Akamatsu, Kiyoshi Hasegawa

Abstract readReview
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In one paragraph

Review 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.

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

10 authors.

Yusuke Seki *Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Yoshikuni Kawaguchi *Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Takeshi KanoHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Kyoji ItoHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Satoru AbeHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Yujiro NishiokaHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Akihiko IchidaHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Takeshi TakamotoHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Nobuhisa AkamatsuHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan.
Kiyoshi HasegawaHepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033, Japan. hasegawa-2su@h.u-tokyo.ac.jp.ORCID http://orcid.org/0000-0001-8734-740X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeRobotic pancreaticoduodenectomy has been increasingly adopted; however, its economic feasibility under the Japanese national health insurance system remains unclear. This study aimed to evaluate the clinical and economic outcomes of robotic pancreaticoduodenectomy (RPD) compared with open pancreaticoduodenectomy (OPD).

methodsPatients who underwent pancreaticoduodenectomy between January 2020 and December 2024 at The University of Tokyo were identified from an institutional database. Patients with pancreatic ductal adenocarcinoma were excluded because portal vein resection and reconstruction performed on a robotic platform were not covered by the Japanese National Health Insurance System during the study period. The clinical outcomes and economic indicators, including hospital revenue, costs, and profit, were assessed under the Japanese lump-sum payment system.

resultsEighty-three patients were included in the study (41 in the robotic group and 42 in the open group). The rate of clinically relevant pancreatic fistula was significantly lower (2.4% vs. 45.2%, P < 0.001), and the median hospital stay was significantly shorter (7.0 vs. 22.5 days, P < 0.001) in the robotic group. The mean hospital revenue per admission (22,007 vs. 19,701 USD, P = 0.015) and profit per day (2,552 vs. 793 USD, P < 0.001) were significantly higher in the robotic group.

conclusionsRobotic pancreaticoduodenectomy yielded superior perioperative outcomes and shorter hospitalization than open pancreaticoduodenectomy in selected patients without compromising hospital revenue per admission.

Indexed as

Cost analysisOpen pancreaticoduodenectomyPancreatic fistulaRobotic pancreaticoduodenectomy

Identifiers

PMID42560533

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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.