Prospective Comparative Study of Short Term Outcomes of Robotic Pancreaticoduodenectomy (RPD) and Laparoscopic Pancreaticoduodenectomy (LPD) in a Large Volume Lpd Centre

Introduction: Surgical resection is the only potentially curative technique for managing pancreatic cancer. Pancreaticoduodenectomy is a technically demanding operation requiring complex resection and intricate anastomosis. Minimally invasive Pancreaticoduodenectomy has evolved significantly in the last two decades. In a high volume centre for LPD, Robotic system was introduced a few years back and a prospective study was conducted to compare the short term outcomes of RPD & LPD, with the primary outcome analysed being POPF. Secondary outcomes analysed included intra-operative and post operative variables, postoperative complications, oncological outcomes including lymph node yield and R0 status, morbidity and 30 day mortality rate. Methods: From Sep 2018- Sep 2020, all patients undergoing RPD and LPD were analysed in a prospective, comparative, single center study. Patients who required conversion to open or who had metastasis on staging laparoscopy were excluded from the study. Results: 52 patients who underwent RPD were compared to 56 patients who underwent LPD during the study period. Patient demographics and pre operative parameters were comparable. Operative times were longer in the RPD group (532+/-124.26 vs 412+/-39.62, p=0.0001). Intra operative blood loss was comparable in both arms. Lymph node yield, R0 status, ICU stay, overall hospital stay, POPF , DGE and PPH were comparable in both arms. there was no mortality in both groups. Conclusions: RPD requires longer operative time but has similar short term post operative outcomes when compared to LPD. Both minimally invasive approaches have similar outcomes with regard to pancreatic fistula & oncological adequacy of resection.