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Robotic versus open pancreaticoduodenectomy in elderly patients: a propensity score-matched analysis.

Authors :
Mederos MA
Starr S
Park JY
King JC
Tomlinson JS
Hines OJ
Donahue TR
Girgis MD
Source :
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2023 Mar; Vol. 25 (3), pp. 301-310. Date of Electronic Publication: 2022 Dec 05.
Publication Year :
2023

Abstract

Background: Pancreaticoduodenectomy (PD) is complex procedure with high morbidity in the elderly. This retrospective study aimed to compare post-operative outcomes in patients ≥75 years of age who underwent robot-assisted (RA)PD and open PD.<br />Methods: We analyzed 2502 patients ≥75 years of age who underwent PD from 2015 to 2018 in the National Surgical Quality Improvement Program (NSQIP) database. RAPD and open PD patients were propensity score matched 1:5 to assess the 30-day outcomes of interest: postoperative complications, length of stay, discharge destination, and readmissions.<br />Results: Of 725 matched patients, 110 underwent RAPD, 615 OPD, and 12 were converted to an open operation. Post-operative outcomes were largely similar between cohorts. RAPD was associated a shorter length of stay (median 8 days, interquartile range [IQR] 6 to 11) than OPD (median 8 days, IQR 7 to 13) (p = 0.003). However, RAPD was associated with more readmissions (28.1% vs. 17.7%; p = 0.02).<br />Conclusions: RAPD in patients ≥75 years of age appears to be safe and has a similar complication profile to open PD. Randomized or well-designed prospective matched studies are needed to confirm these findings.<br /> (Copyright © 2022 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Details

Language :
English
ISSN :
1477-2574
Volume :
25
Issue :
3
Database :
MEDLINE
Journal :
HPB : the official journal of the International Hepato Pancreato Biliary Association
Publication Type :
Academic Journal
Accession number :
36529625
Full Text :
https://doi.org/10.1016/j.hpb.2022.11.011