Detailed Abstract
[BP Oral Presentation 2 - Biliary & Pancreas (Pancreas Disease/Surgery)]
[BP OP 2-S3] Evaluation of Benefit of Robotic Pancreatoduodenectomy (PD) Focusing on Pancreatic Fistula As Well As Complication Comparing with Open PD Using Alternative Fistula Risk Score
CHARNWIT ASSAWASIRISIN 1, YOUNGMIN HAN 1, HYE-SOL JUNG 1, WOOIL KWON 1, MIRANG LEE 1, WON-GUN YUN 1, YOONSOO CHAE 1, JIN-YOUNG JANG 1
1 Surgery, Seoul National University Hospital, REPUBLIC OF KOREA, 2 Surgery, Siriraj Hospital, THAILAND
Background : The widespread adoption of robotic pancreatoduodenectomy (RPD) has been driven by its anastomosis creation advantage. However, the benefit in terms of pancreatic fistula remains despite various studies. This study investigates the safety of RPD utilizing the Alternative Fistula Risk Score (aFRS) for comparison with open pancreatoduodenectomy (OPD).
Methods : A retrospective analysis was conducted on the prospectively maintained database at SNUH from 2014 to 2023. In this period, 1,453 OPD and 635 RPD were performed. Peri-operative data were collected. Patients were matched at a 1:1 ratio based on aFRS probability to compare outcomes between OPD and RPD. The analysis was stratified according to aFRS.
Results : A total of 2,088 patients (pre-matching) and 1,206 patients (post-matching) were included. Prior to matching, RPD patients exhibited similar BMI, a higher proportion of soft pancreatic texture, a smaller pancreatic duct, and a higher aFRS probability compared to OPD patients. RPD showed no statistical difference in pancreatic fistula (PF) (57% vs. 54%, p = 0.12) and clinically relevant PF (CR-PF) (11% vs. 10%, p = 0.75), but less delayed gastric emptying (DGE) and wound complication. Post-matching, no significant differences were observed for baseline characteristics. In the low- and intermediate-risk groups, there were no statistical differences. However, in the high-risk group, RPD demonstrated lower rates of all PF (81% vs. 66%, p < 0.001), wound complications, DGE, and a marginal reduction in CR-PF (17% vs. 11%, p = 0.059).
Conclusions : This study supports the safety of RPD comparable to OPD and suggests potential advantages, especially in high-risk aFRS cases.
Methods : A retrospective analysis was conducted on the prospectively maintained database at SNUH from 2014 to 2023. In this period, 1,453 OPD and 635 RPD were performed. Peri-operative data were collected. Patients were matched at a 1:1 ratio based on aFRS probability to compare outcomes between OPD and RPD. The analysis was stratified according to aFRS.
Results : A total of 2,088 patients (pre-matching) and 1,206 patients (post-matching) were included. Prior to matching, RPD patients exhibited similar BMI, a higher proportion of soft pancreatic texture, a smaller pancreatic duct, and a higher aFRS probability compared to OPD patients. RPD showed no statistical difference in pancreatic fistula (PF) (57% vs. 54%, p = 0.12) and clinically relevant PF (CR-PF) (11% vs. 10%, p = 0.75), but less delayed gastric emptying (DGE) and wound complication. Post-matching, no significant differences were observed for baseline characteristics. In the low- and intermediate-risk groups, there were no statistical differences. However, in the high-risk group, RPD demonstrated lower rates of all PF (81% vs. 66%, p < 0.001), wound complications, DGE, and a marginal reduction in CR-PF (17% vs. 11%, p = 0.059).
Conclusions : This study supports the safety of RPD comparable to OPD and suggests potential advantages, especially in high-risk aFRS cases.
SESSION
BP Oral Presentation 2
Room C 3/22/2024 4:30 PM - 5:30 PM