Total robotic pancreaticoduodenectomy: a systematic review of the literature.

Journal Article (Systematic Review;Review;Journal Article)


Pancreaticoduodenectomy (PD) is a complex operation with high perioperative morbidity and mortality, even in the highest volume centers. Since the development of the robotic platform, the number of reports on robotic-assisted pancreatic surgery has been on the rise. This article reviews the current state of completely robotic PD.

Materials and methods

A systematic literature search was performed including studies published between January 2000 and July 2016 reporting PDs in which all procedural steps (dissection, resection and reconstruction) were performed robotically.


Thirteen studies met the inclusion criteria, including a total of 738 patients. Data regarding perioperative outcomes such as operative time, blood loss, mortality, morbidity, conversion and oncologic outcomes were analyzed. No major differences were observed in mortality, morbidity and oncologic parameters, between robotic and non-robotic approaches. However, operative time was longer in robotic PD, whereas the estimated blood loss was lower. The conversion rate to laparotomy was 6.5-7.8%.


Robotic PD is feasible and safe in high-volume institutions, where surgeons are experienced and medical staff are appropriately trained. Randomized controlled trials are required to further investigate outcomes of robotic PD. Additionally, cost analysis and data on long-term oncologic outcomes are needed to evaluate cost-effectiveness of the robotic approach in comparison with the open technique.

Full Text

Duke Authors

Cited Authors

  • Kornaropoulos, M; Moris, D; Beal, EW; Makris, MC; Mitrousias, A; Petrou, A; Felekouras, E; Michalinos, A; Vailas, M; Schizas, D; Papalampros, A

Published Date

  • November 2017

Published In

Volume / Issue

  • 31 / 11

Start / End Page

  • 4382 - 4392

PubMed ID

  • 28389798

Electronic International Standard Serial Number (EISSN)

  • 1432-2218

International Standard Serial Number (ISSN)

  • 0930-2794

Digital Object Identifier (DOI)

  • 10.1007/s00464-017-5523-z


  • eng