Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study

Anouk M L H Emmen; Maurice J W Zwart; Igor E Khatkov; Ugo Boggi; Bas Groot Koerkamp; Olivier R Busch; Olivier Saint-Marc; Safi Dokmak; I Quintus Molenaar; Mathieu D'Hondt; Marco Ramera; Tobias Keck; Giovanni Ferrari; Misha D P Luyer; Luca Moraldi; Benedetto Ielpo; Uwe Wittel; Francois-Regis Souche; Thilo Hackert; Daan Lips; Mehmet Fatih Can; Koop Bosscha; Regis Fara; Sebastiaan Festen; Susan van Dieren; Andrea Coratti; Ignace De Hingh; Michele Mazzola; Ulrich Wellner; Celine De Meyere; Hjalmar C van Santvoort; Béatrice Aussilhou; Abdallah Ibenkhayat; Roeland F de Wilde; Emanuele F Kauffmann; Pavel Tyutyunnik; Marc G Besselink; Mohammad Abu Hilal; European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)

doi:10.1016/j.surg.2024.02.015

Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study

Standard

Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study. / Emmen, Anouk M L H; Zwart, Maurice J W; Khatkov, Igor E; Boggi, Ugo; Groot Koerkamp, Bas; Busch, Olivier R; Saint-Marc, Olivier; Dokmak, Safi; Molenaar, I Quintus; D'Hondt, Mathieu; Ramera, Marco; Keck, Tobias; Ferrari, Giovanni; Luyer, Misha D P; Moraldi, Luca; Ielpo, Benedetto; Wittel, Uwe; Souche, Francois-Regis; Hackert, Thilo; Lips, Daan; Can, Mehmet Fatih; Bosscha, Koop; Fara, Regis; Festen, Sebastiaan; van Dieren, Susan; Coratti, Andrea; De Hingh, Ignace; Mazzola, Michele; Wellner, Ulrich; De Meyere, Celine; van Santvoort, Hjalmar C; Aussilhou, Béatrice; Ibenkhayat, Abdallah; de Wilde, Roeland F; Kauffmann, Emanuele F; Tyutyunnik, Pavel; Besselink, Marc G; Abu Hilal, Mohammad; European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS).

In: SURGERY, Vol. 175, No. 6, 06.2024, p. 1587-1594.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Emmen, AMLH, Zwart, MJW, Khatkov, IE, Boggi, U, Groot Koerkamp, B, Busch, OR, Saint-Marc, O, Dokmak, S, Molenaar, IQ, D'Hondt, M, Ramera, M, Keck, T, Ferrari, G, Luyer, MDP, Moraldi, L, Ielpo, B, Wittel, U, Souche, F-R, Hackert, T, Lips, D, Can, MF, Bosscha, K, Fara, R, Festen, S, van Dieren, S, Coratti, A, De Hingh, I, Mazzola, M, Wellner, U, De Meyere, C, van Santvoort, HC, Aussilhou, B, Ibenkhayat, A, de Wilde, RF, Kauffmann, EF, Tyutyunnik, P, Besselink, MG, Abu Hilal, M & European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) 2024, 'Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study', SURGERY, vol. 175, no. 6, pp. 1587-1594. https://doi.org/10.1016/j.surg.2024.02.015

APA

Emmen, A. M. L. H., Zwart, M. J. W., Khatkov, I. E., Boggi, U., Groot Koerkamp, B., Busch, O. R., Saint-Marc, O., Dokmak, S., Molenaar, I. Q., D'Hondt, M., Ramera, M., Keck, T., Ferrari, G., Luyer, M. D. P., Moraldi, L., Ielpo, B., Wittel, U., Souche, F-R., Hackert, T., ... European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS) (2024). Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study. SURGERY, 175(6), 1587-1594. https://doi.org/10.1016/j.surg.2024.02.015

Vancouver

Emmen AMLH, Zwart MJW, Khatkov IE, Boggi U, Groot Koerkamp B, Busch OR et al. Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study. SURGERY. 2024 Jun;175(6):1587-1594. https://doi.org/10.1016/j.surg.2024.02.015

Bibtex

@article{60a179f775c54308a79863d0763e6fd7,

title = "Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study",

abstract = "BACKGROUND: The use of robot-assisted and laparoscopic pancreatoduodenectomy is increasing, yet large adjusted analyses that can be generalized internationally are lacking. This study aimed to compare outcomes after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy in a pan-European cohort.METHODS: An international multicenter retrospective study including patients after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy from 50 centers in 12 European countries (2009-2020). Propensity score matching was performed in a 1:1 ratio. The primary outcome was major morbidity (Clavien-Dindo ≥III).RESULTS: Among 2,082 patients undergoing minimally invasive pancreatoduodenectomy, 1,006 underwent robot-assisted pancreatoduodenectomy and 1,076 laparoscopic pancreatoduodenectomy. After matching 812 versus 812 patients, the rates of major morbidity (31.9% vs 29.6%; P = .347) and 30-day/in-hospital mortality (4.3% vs 4.6%; P = .904) did not differ significantly between robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy, respectively. Robot-assisted pancreatoduodenectomy was associated with a lower conversion rate (6.7% vs 18.0%; P < .001) and higher lymph node retrieval (16 vs 14; P = .003). Laparoscopic pancreatoduodenectomy was associated with shorter operation time (446 minutes versus 400 minutes; P < .001), and lower rates of postoperative pancreatic fistula grade B/C (19.0% vs 11.7%; P < .001), delayed gastric emptying grade B/C (21.4% vs 7.4%; P < .001), and a higher R0-resection rate (73.2% vs 84.4%; P < .001).CONCLUSION: This European multicenter study found no differences in overall major morbidity and 30-day/in-hospital mortality after robot-assisted pancreatoduodenectomy compared with laparoscopic pancreatoduodenectomy. Further, laparoscopic pancreatoduodenectomy was associated with a lower rate of postoperative pancreatic fistula, delayed gastric emptying, wound infection, shorter length of stay, and a higher R0 resection rate than robot-assisted pancreatoduodenectomy. In contrast, robot-assisted pancreatoduodenectomy was associated with a lower conversion rate and a higher number of retrieved lymph nodes as compared with laparoscopic pancreatoduodenectomy.",

keywords = "Humans, Pancreaticoduodenectomy/methods, Male, Female, Robotic Surgical Procedures/adverse effects, Laparoscopy/methods, Retrospective Studies, Propensity Score, Middle Aged, Europe/epidemiology, Aged, Postoperative Complications/epidemiology, Hospital Mortality, Pancreatic Neoplasms/surgery, Treatment Outcome",

author = "Emmen, {Anouk M L H} and Zwart, {Maurice J W} and Khatkov, {Igor E} and Ugo Boggi and {Groot Koerkamp}, Bas and Busch, {Olivier R} and Olivier Saint-Marc and Safi Dokmak and Molenaar, {I Quintus} and Mathieu D'Hondt and Marco Ramera and Tobias Keck and Giovanni Ferrari and Luyer, {Misha D P} and Luca Moraldi and Benedetto Ielpo and Uwe Wittel and Francois-Regis Souche and Thilo Hackert and Daan Lips and Can, {Mehmet Fatih} and Koop Bosscha and Regis Fara and Sebastiaan Festen and {van Dieren}, Susan and Andrea Coratti and {De Hingh}, Ignace and Michele Mazzola and Ulrich Wellner and {De Meyere}, Celine and {van Santvoort}, {Hjalmar C} and B{\'e}atrice Aussilhou and Abdallah Ibenkhayat and {de Wilde}, {Roeland F} and Kauffmann, {Emanuele F} and Pavel Tyutyunnik and Besselink, {Marc G} and {Abu Hilal}, Mohammad and {European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)}",

year = "2024",

month = jun,

doi = "10.1016/j.surg.2024.02.015",

language = "English",

volume = "175",

pages = "1587--1594",

journal = "SURGERY",

issn = "0039-6060",

publisher = "Mosby Inc.",

number = "6",

}

RIS

TY - JOUR

T1 - Robot-assisted versus laparoscopic pancreatoduodenectomy: a pan-European multicenter propensity-matched study

AU - Emmen, Anouk M L H

AU - Zwart, Maurice J W

AU - Khatkov, Igor E

AU - Boggi, Ugo

AU - Groot Koerkamp, Bas

AU - Busch, Olivier R

AU - Saint-Marc, Olivier

AU - Dokmak, Safi

AU - Molenaar, I Quintus

AU - D'Hondt, Mathieu

AU - Ramera, Marco

AU - Keck, Tobias

AU - Ferrari, Giovanni

AU - Luyer, Misha D P

AU - Moraldi, Luca

AU - Ielpo, Benedetto

AU - Wittel, Uwe

AU - Souche, Francois-Regis

AU - Hackert, Thilo

AU - Lips, Daan

AU - Can, Mehmet Fatih

AU - Bosscha, Koop

AU - Fara, Regis

AU - Festen, Sebastiaan

AU - van Dieren, Susan

AU - Coratti, Andrea

AU - De Hingh, Ignace

AU - Mazzola, Michele

AU - Wellner, Ulrich

AU - De Meyere, Celine

AU - van Santvoort, Hjalmar C

AU - Aussilhou, Béatrice

AU - Ibenkhayat, Abdallah

AU - de Wilde, Roeland F

AU - Kauffmann, Emanuele F

AU - Tyutyunnik, Pavel

AU - Besselink, Marc G

AU - Abu Hilal, Mohammad

AU - European consortium on Minimally Invasive Pancreatic Surgery (E-MIPS)

PY - 2024/6

Y1 - 2024/6

N2 - BACKGROUND: The use of robot-assisted and laparoscopic pancreatoduodenectomy is increasing, yet large adjusted analyses that can be generalized internationally are lacking. This study aimed to compare outcomes after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy in a pan-European cohort.METHODS: An international multicenter retrospective study including patients after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy from 50 centers in 12 European countries (2009-2020). Propensity score matching was performed in a 1:1 ratio. The primary outcome was major morbidity (Clavien-Dindo ≥III).RESULTS: Among 2,082 patients undergoing minimally invasive pancreatoduodenectomy, 1,006 underwent robot-assisted pancreatoduodenectomy and 1,076 laparoscopic pancreatoduodenectomy. After matching 812 versus 812 patients, the rates of major morbidity (31.9% vs 29.6%; P = .347) and 30-day/in-hospital mortality (4.3% vs 4.6%; P = .904) did not differ significantly between robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy, respectively. Robot-assisted pancreatoduodenectomy was associated with a lower conversion rate (6.7% vs 18.0%; P < .001) and higher lymph node retrieval (16 vs 14; P = .003). Laparoscopic pancreatoduodenectomy was associated with shorter operation time (446 minutes versus 400 minutes; P < .001), and lower rates of postoperative pancreatic fistula grade B/C (19.0% vs 11.7%; P < .001), delayed gastric emptying grade B/C (21.4% vs 7.4%; P < .001), and a higher R0-resection rate (73.2% vs 84.4%; P < .001).CONCLUSION: This European multicenter study found no differences in overall major morbidity and 30-day/in-hospital mortality after robot-assisted pancreatoduodenectomy compared with laparoscopic pancreatoduodenectomy. Further, laparoscopic pancreatoduodenectomy was associated with a lower rate of postoperative pancreatic fistula, delayed gastric emptying, wound infection, shorter length of stay, and a higher R0 resection rate than robot-assisted pancreatoduodenectomy. In contrast, robot-assisted pancreatoduodenectomy was associated with a lower conversion rate and a higher number of retrieved lymph nodes as compared with laparoscopic pancreatoduodenectomy.

AB - BACKGROUND: The use of robot-assisted and laparoscopic pancreatoduodenectomy is increasing, yet large adjusted analyses that can be generalized internationally are lacking. This study aimed to compare outcomes after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy in a pan-European cohort.METHODS: An international multicenter retrospective study including patients after robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy from 50 centers in 12 European countries (2009-2020). Propensity score matching was performed in a 1:1 ratio. The primary outcome was major morbidity (Clavien-Dindo ≥III).RESULTS: Among 2,082 patients undergoing minimally invasive pancreatoduodenectomy, 1,006 underwent robot-assisted pancreatoduodenectomy and 1,076 laparoscopic pancreatoduodenectomy. After matching 812 versus 812 patients, the rates of major morbidity (31.9% vs 29.6%; P = .347) and 30-day/in-hospital mortality (4.3% vs 4.6%; P = .904) did not differ significantly between robot-assisted pancreatoduodenectomy and laparoscopic pancreatoduodenectomy, respectively. Robot-assisted pancreatoduodenectomy was associated with a lower conversion rate (6.7% vs 18.0%; P < .001) and higher lymph node retrieval (16 vs 14; P = .003). Laparoscopic pancreatoduodenectomy was associated with shorter operation time (446 minutes versus 400 minutes; P < .001), and lower rates of postoperative pancreatic fistula grade B/C (19.0% vs 11.7%; P < .001), delayed gastric emptying grade B/C (21.4% vs 7.4%; P < .001), and a higher R0-resection rate (73.2% vs 84.4%; P < .001).CONCLUSION: This European multicenter study found no differences in overall major morbidity and 30-day/in-hospital mortality after robot-assisted pancreatoduodenectomy compared with laparoscopic pancreatoduodenectomy. Further, laparoscopic pancreatoduodenectomy was associated with a lower rate of postoperative pancreatic fistula, delayed gastric emptying, wound infection, shorter length of stay, and a higher R0 resection rate than robot-assisted pancreatoduodenectomy. In contrast, robot-assisted pancreatoduodenectomy was associated with a lower conversion rate and a higher number of retrieved lymph nodes as compared with laparoscopic pancreatoduodenectomy.

KW - Humans

KW - Pancreaticoduodenectomy/methods

KW - Male

KW - Female

KW - Robotic Surgical Procedures/adverse effects

KW - Laparoscopy/methods

KW - Retrospective Studies

KW - Propensity Score

KW - Middle Aged

KW - Europe/epidemiology

KW - Aged

KW - Postoperative Complications/epidemiology

KW - Hospital Mortality

KW - Pancreatic Neoplasms/surgery

KW - Treatment Outcome

U2 - 10.1016/j.surg.2024.02.015

DO - 10.1016/j.surg.2024.02.015

M3 - SCORING: Journal article

C2 - 38570225

VL - 175

SP - 1587

EP - 1594

JO - SURGERY

JF - SURGERY

SN - 0039-6060

IS - 6

ER -