The surgical indications for pancreaticoduodenectomy have been expanded to include older patients because of surgical methods and postoperative care improvements. However, it was unclear if robotic pancreaticoduodenectomy (RPD) was better than open pancreaticoduodenectomy (OPD) for elderly patients. Thus, for a study, researchers sought to evaluate the perioperative results of RPD vs. OPD in older patients.
A retrospective analysis was done on a group of elderly patients ( aged≥75 years) who underwent RPD or OPD at 7 pancreatic facilities in China between July 2011 and July 2020 to determine their demographics and perioperative outcomes.
About 100 and 69% of participants in the study’s 302 patient population received RPD, while 133 underwent OPD. The RPD group outperformed the OPD group in terms of both operational time (264.3 vs. 278.2 min, P=0.01) and estimated blood loss (EBL) (100 (50,150) vs. 200 (150,300) mL, P<0.001). Three patients’ RPDs (1.8%) were changed to OPDs. The postoperative length of stay (LOS) following RPD was considerably lower than that following OPD (13.0 vs. 17.0 days, P<0.001). No appreciable differences (P>0.05) were discovered between the two groups in the incidences of clinically relevant postoperative pancreatic fistula, bile leakage, delayed gastric emptying, postoperative pancreatectomy hemorrhage, major morbidity, reoperation, 90-day readmission, or 90-day mortality. The multivariate logistic regression analysis identified type 2 diabetes, chronic obstructive pulmonary disease, surgical bleeding, and cardiac events as independent risk factors for postoperative 90-day death.
In older patients with shorter OT, lower EBL, and shorter postoperative LOS, the study showed that RPD was as safe and feasible as OPD. The method of surgery was not a standalone risk factor for 90-day death.
Reference: sciencedirect.com/science/article/abs/pii/S1743919122005969
