Short-term efficacy and safety of Da Vinci robotic pancreaticoduodenectomy versus traditional laparoscopic pancreaticoduodenectomy: A meta-analysis / 临床肝胆病杂志

ABSTRACT

Objective To systematically evaluate the short-term efficacy and safety of robotic pancreaticoduodenectomy (RPD) versus traditional laparoscopic pancreaticoduodenectomy (LPD), and to provide a reference for clinical research and practice. Methods Chinese and English databases such as PubMed, Embase, the Cochrane Library, CNKI, Wanfang Data, and VIP were searched to include the cohort studies comparing the clinical efficacy of robot-assisted laparoscopy and traditional laparoscopy in pancreaticoduodenectomy. The quality of included articles was evaluated based on Cochrane systematic review, and Stata15.1 software was used to perform a meta-analysis of related outcome measures extracted. Results A total of 12 cohort studies were included, with 1630 patients in total, and there were 683 patients in the RPD group and 947 patients in the LPD group. The meta-analysis showed that there were significant differences between the RPD group and the LPD group in postoperative bleeding rate (odds ratio [ OR ]=0.66, 95% confidence interval [ CI ] 0.48-0.91, P < 0.05), rate of conversion to laparotomy ( OR =0.41, 95% CI 0.30-0.56, P < 0.05), estimated intraoperative blood loss (weighted mean difference [ WMD ]=-0.77, 95% CI -1.33 to -0.22, P < 0.05), and length of postoperative hospital stay (WMD=-0.45, 95% CI -0.80 to -0.11, P < 0.05). Country of publication might be one of the sources of heterogeneity in the incidence rate of postoperative complications between subgroups ( P < 0.05). Conclusion Compared with traditional LPD, da Vinci RPD can reduce postoperative bleeding rate, intraoperative blood loss and rate of conversion to laparotomy and shorten postoperative hospital stay, and meanwhile, it does not increase the operation time and the incidence rate of postoperative complications. Both surgical procedures are safe and feasible.