Researchers found similar perioperative and survival outcomes in patients with distal cholangiocarcinoma (CCA) undergoing robotic pancreatoduodenectomy (RPD) vs traditional open pancreatoduodenectomy (OPD), as published in Surgical Endoscopy.

The multicenter, propensity score-matched study assessed 180 patients in each surgical group, finding similar safety, feasibility, and outcomes between the 2 approaches.

“Since RPD was first reported in 2003, an increasing number of high-volume surgical centers around the world have been progressively performing RPD and have demonstrated that RPD is safe and feasible after a learning curve,” the authors explained.

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“In the present study, we retrospectively analyzed the perioperative and follow-up data from a multicenter sample of [distal CCA] patients who underwent RPD and OPD in China to compare the short-term and long-term oncological outcomes of RPD and OPD for [distal CCA].”

The research team conducted a retrospective study on patients with distal CCA who underwent RPD or OPD between 2014 and 2019. After propensity score matching, the patients in the RPD group experienced significantly less blood loss and a shorter length of hospital stay than the patients undergoing OPD. Operative times were similar between the groups, as were the number of lymph nodes harvested and intraoperative use of blood transfusions.

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In terms of outcomes, the groups were also similar in measures of major morbidity, reoperation, and 90-day mortality. The long-term survival of the patients was not significantly affected by the choice of surgical approach.

The authors note that various factors, such as carbohydrate antigen 19-9 levels, surgical margin status, perineural invasion, tumor differentiation, and lymph node metastasis were independent prognostic factors for overall survival and disease-free survival among all patients, regardless of the surgical approach.

The authors recommend further studies to assess RPD and OPD in countries other than China, as well as an analysis of hospital costs related to the procedures, with the aim of further elucidating the optimal approach for patients with distal CCA.


Xu S, Zhang XP, Zhao GD, et al. Robotic versus open pancreaticoduodenectomy for distal cholangiocarcinoma: a multicenter propensity score-matched study. Surg Endosc. Published online May 9, 2022. doi:10.1007/s00464-022-09271-1