Evidence map›Paper›PMID 42834181›Full record

ArticleSurgical endoscopy2026

Adjusted trend analysis in the adoption and outcomes of minimally invasive pancreaticoduodenectomy approaches: over a decade of contemporary U.S. data.

Laleh Foroutani, Allison Chang, Architha Kannan, Amir Ashraf Ganjouei, Jane Wang, Jean Feng, Lucas Thornblade, Kenzo Hirose, Ajay V Maker, Eric Nakakura and 3 more

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 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

13 authors.

Laleh Foroutani *Department of Surgery, University of California, San Francisco, CA, USA.
Allison Chang *Department of Surgery, University of California, San Francisco, CA, USA.
Architha KannanDepartment of Surgery, University of California, San Francisco, CA, USA.
Amir Ashraf GanjoueiDepartment of Surgery, University of California, San Francisco, CA, USA.
Jane WangDepartment of Surgery, University of California, San Francisco, CA, USA.
Jean FengDepartment of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA.
Lucas ThornbladeDepartment of Surgery, University of California, San Francisco, CA, USA.
Kenzo HiroseDepartment of Surgery, University of California, San Francisco, CA, USA.
Ajay V MakerDepartment of Surgery, University of California, San Francisco, CA, USA.
Eric NakakuraDepartment of Surgery, University of California, San Francisco, CA, USA.
Carlos CorveraDepartment of Surgery, University of California, San Francisco, CA, USA.
Adnan AlseidiDepartment of Surgery, University of California, San Francisco, CA, USA.
Mohamed Abdelgadir AdamDepartment of Surgery, University of California, San Francisco, CA, USA. mohamed.adam@ucsf.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPancreaticoduodenectomy (PD) remains one of the most technically demanding abdominal procedures and is traditionally performed via open approach (OPD). Although adoption of minimally invasive PD (MIPD) has lagged, advances in robotic technology and structured training may be reshaping national practice patterns. This study evaluated temporal trends in the adoption of MIPD, including laparoscopic (LPD) and robotic (RPD), and compared associated postoperative outcomes.

methodsAdult patients undergoing PD were identified from the National Cancer Database (2010-2024) and the National Surgical Quality Improvement Program (2014-2024). Temporal trends were assessed using joinpoint regression, reporting annual percent change (APC). For the matched outcome analysis, the NCDB cohort was restricted to patients with pancreatic ductal adenocarcinoma, and patients undergoing each approach were matched by clinical stage, facility type, and age category. Conversion, lymph-node yield, margin status, length of stay, readmission, postoperative pancreatic fistula, and mortality were compared.

resultsAmong 65,221 NCDB patients, OPD remained the predominant approach (74.5%); however, MIPD utilization increased significantly (APC +7.1%), reaching 34.9% of cases by 2024. LPD comprised 66.9% of MIPD cases and demonstrated early growth from 2010-2017 (APC +6.2%) before declining modestly after 2017. In contrast, RPD showed sustained expansion, increasing nearly 17-fold from 1.1% in 2010 to 18.6% in 2024. In the matched cohort, RPD was associated with the shortest median length of stay (6 vs 7 days for LPD and 8 days for OPD; p<0.001), and a slightly higher lymph-node yield. Conversion rates declined significantly for both minimally invasive approaches, with lower overall conversion for RPD compared to LPD.

conclusionsOver the study period, OPD declined while MIPD adoption increased substantially, driven primarily by rapid growth in RPD. These temporal changes may reflect increasing institutional experience and maturation of the technique. These findings highlight evolving national practice patterns and may inform future training and resource allocation in pancreatic surgery.

Indexed as

Joinpoint regressionLaparoscopic surgeryMinimally invasive pancreaticoduodenectomyPancreaticoduodenectomyRobotic surgery

Identifiers

PMID42834181

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.