Robotic Whipple for pancreatic ductal and ampullary adenocarcinoma: 10 years experience of a US single‐center

Abstract

BACKGROUND: There is currently ample consensus about the safety and feasibility of robotic pancreaticoduodenectomy (RPD). However, few studies are available on the long-term oncological outcomes of this procedure. We present a long-term survival analysis (up to 10 years) of our series of RPD carried out for ductal and ampullary adenocarcinoma. METHODS: A retrospective analysis of a prospectively collected approved database was carried out including 39 patients who underwent RPD for pancreatic ductal and ampullary adenocarcinomas. RESULTS: The 5-year overall survival for ductal and ampullary carcinoma was 41% with an estimated median and mean survival of 27 and 52 months. The ampullary group had significantly longer 5-year survival (68%) than the ductal group (30%). CONCLUSION: Our data show, within the limitations of their retrospective nature, that robotic pancreaticoduodenectomy provides similar short-and long-term survival outcomes compared to open technique in the treatment of pancreatic ductal and ampullary adenocarcinoma.

Surgical and survival outcomes after robotic and open pancreatoduodenectomy for ampullary cancer: a propensity score-matching comparison

“…Thus, symptoms like jaundice, anemia, and pain often occur earlier compared with other malignant pancreatobiliary tumors like pancreatic cancer 3,29 . This is possibly one reason for the favorable prognoses for ampullary cancers, compared to pancreatic head and other periampullary cancers [11][12][13]30 . The surgical radicality is similar between RPD and OPD groups.…”

“…Data regarding the outcomes of RPD in ampullary cancer patients is limited, largely because of the rarity of the disease and the paucity of related research. Moreover, most studies included both pancreatic head cancer and other periampullary lesions; therefore, the outcomes of RPD could not be addressed because of heterogeneous pathologies [11][12][13] . To our knowledge, no report of RPD mainly focused on ampullary cancers.…”

From endoscopic resection to pancreatoduodenectomy: a narrative review of treatment modalities for the tumors of the ampulla of Vater

“…On the side, perioperative outcomes such as postoperative length of stay and quality of life after surgery seem to be superior for patients treated laparoscopically (29,30). Valle et al (31) described their 10-year experience with robotic PD for AT, showing comparable outcomes to those described in the literature for open surgery. It is plausible that robotic will soon reach the same results of laparoscopic surgery.…”

An invited commentary on: “Robotic pancreaticoduodenectomy in elderly and young patients: A retrospective cohort study” (International Journal of Surgery 2020; 81:61–65)

“…An uncomplicated recovery from surgery is important to start adjuvant therapy without delay, at an adequate dose and without interruption. Despite that, it remains relatively poor with only around 40% 5y survival in most series for both open and minimally invasive PD [3].…”