Which method of distal pancreatectomy is cost-effective among open, laparoscopic, or robotic surgery?

Abstract : Background: The aim of this study was to analyze the clinical and economic impact of robotic distal pancreatectomy, laparoscopic distal pancreatectomy, and open distal pancreatectomy. Methods: All consecutive patients who underwent distal pancreatic resection for benign and malignant diseases between January 2012 and December 2015 were prospectively included. Cost analysis was performed; all charges from patient admission to discharge were considered. Results: There were 21 robotic (RDP), 25 laparoscopic (LDP), and 43 open (ODP) procedures. Operative time was longer in the RDP group (RDP =345 minutes, LDP =306 min, ODP =251 min, P=0.01). Blood loss was higher in the ODP group (RDP =192 mL, LDP =356 mL, ODP =573 mL, P=0.0002). Spleen preservation was more frequent in the RDP group (RDP =66.6%, LDP =61.9%, ODP =9.3%, P=0.001). The rate of patients with Clavien-Dindo > grade III was higher in the ODP group (RDP =0%, LDP =12%, ODP =23%, P=0.01), especially for non-surgical complications, which were more frequent in the ODP group (RDP =9.5%, LDP =24%, ODP =41.8%, P=0.02). Length of hospital stay was increased in the ODP group (ODP =19 days, LDP =13 days, RDP =11 days, P=0.007). The total cost of the procedure, including the surgical procedure and postoperative course was higher in the ODP group (ODP =30,929 Euros, LDP =22,150 Euros, RDP =21,219 Euros, P=0.02). Conclusions: Cost-effective results of RDP seem to be similar to LDP with some better short-term outcomes.
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Contributeur : Anthony Herrada <>
Soumis le : mercredi 9 octobre 2019 - 16:46:49
Dernière modification le : vendredi 11 octobre 2019 - 01:24:01

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Maylis Rodriguez, Riccardo Memeo, Piera Leon, Fabrizio Panaro, Stylianos Tzedakis, et al.. Which method of distal pancreatectomy is cost-effective among open, laparoscopic, or robotic surgery?. Hepatobiliary Surgery and Nutrition, AME Publishing Company, 2018, 7 (5), pp.345-352. ⟨10.21037/hbsn.2018.09.03⟩. ⟨hal-02309931⟩

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