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Systematic review and meta-analysis of robotic versus laparoscopic distal pancreatectomy for benign and malignant pancreatic lesions

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Abstract

Background and objective

The number of published series on minimally invasive distal pancreatectomy has significantly increased. Robotic systems can overcome some limitations of laparoscopy. This study aimed to compare two techniques in distal pancreatectomy.

Methods

Multiple electronic databases were systematically searched to identify studies (up to July 2015) that compared perioperative outcomes between robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP). Relative risks with 95 % confidence intervals (CIs) were estimated.

Results

Nine studies were enrolled in this review. Four studies reported on operative time, indicating no difference between the RDP and LDP groups (WMD = 21.55, 95 % CI −65.28–108.37, P = 0.63). No significant difference between the two groups was indicated with respect to the number of patients who converted to open (OR 0.35, 95 % CI 0.11–1.13, P = 0.08), spleen preservation rate (OR 2.37, 95 % CI 0.50–11.30, P = 0.28), and transfusion rate (OR 1.30, 95 % CI 0.54–3.13, P = 0.56). In addition, no difference was indicated in the incidence of pancreatic fistulas (OR 1.05, 95 % CI 0.67–1.65, P = 0.83) and length of hospital stay between the two groups (WMD = −0.61, 95 % CI −1.40–0.19, P = 0.13).

Conclusions

RDP seems to be a safe and effective alternative to LDP. Large randomized controlled trials are needed to verify the results of this meta-analysis.

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Acknowledgments

All of the authors contributed to the collection and analysis of the data and to the preparation of the report. The corresponding author had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

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Author notes

    Authors and Affiliations

    1. Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China

      Bin Huang & Jichun Zhao

    2. Department of Emergency Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People’s Hospital, Chengdu, 610072, Sichuan Province, China

      Lu Feng

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    1. Bin Huang
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    Correspondence to Jichun Zhao.

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    Drs. Bin Huang, Lu Feng, and Jichun Zhao have no conflicts of interest or financial ties to disclose.

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    Bin Huang and Lu Feng have contributed equally to this study.

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    Huang, B., Feng, L. & Zhao, J. Systematic review and meta-analysis of robotic versus laparoscopic distal pancreatectomy for benign and malignant pancreatic lesions. Surg Endosc 30, 4078–4085 (2016). https://doi.org/10.1007/s00464-015-4723-7

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    • DOI: https://doi.org/10.1007/s00464-015-4723-7

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