Meta-analysis of the Comparison between Robotic and Open Pancreatoduodenectomy
SONG Tao,HAN Dong,JIN Zhong-kui
Tianjin Nankai Hospital, Tianjin 300100,China
Abstract:
Objective To systematically evaluate the outcomes of robot-assisted pancreaticoduodenectomy(RPD) and open pancreaticoduodenectomy (OPD). Methods Literatures were researched using PubMed,Embase, Web of Science, Cochrane Library, CNKI, Wanfang and VIP database with the Keywords including pancreaticoduodenectomy, duodenopanreatectpmy, whipple, robotic, Da Vinci. To investigate the differences of the mortality, duration of surgery, blood loss, incidence of pancreatic fistula, delayed gastric emptying, surgical site infection, hemorrhage and the hospital stay between two groups. RevMan 5.3 was used to perform the Metaanalysis.Results Twenty-two studies were enrolled in this Meta-analysis. A total of 21 653 patients were enrolled, including 2 401 in the RPD group and 19 252 in the OPD group. The results of Meta-analysis showed that there were no significant differences in the mortality (OR=0.80, 95%CI: 0.48-1.32, P =0.39)，incidence of pancreatic fistula (OR=0.85, 95%CI: 0.63-1.15, P =0.29) and delayed gastric emptying (OR=1.12, 95%CI:0.79-1.59, P =0.53) between two groups. The operative time (WMD ＝ 66.12, 95%CI: 6.38-125.87, P =0.03)，blood loss (WMD=-200.18, 95%CI: -322.84~-77.53, P =0.001), surgical site infection (OR=0.48, 95%CI: 0.1-0.74, P <0.01), postoperative hemorrhage (OR ＝ 0.69, 95%CI: 0.57-0.85, P <0.01) and hospital stay (WMD＝ -2.86, 95%CI: -5.14~-0.58, P =0.01) were significant lower in the RPD group than those of in the OPD group. Conclusion RPD is as safe as OPD, with the same complication rate, and reduced operative time, blood loss, hospital stay, rate of surgical site infection and postoperative hemorrhage.
