Literature DB >> 30498710

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

Maylis Rodriguez1, Riccardo Memeo1,2,3, Piera Leon4, Fabrizio Panaro4, Stylianos Tzedakis1, Ornella Perotto1, Sharmini Varatharajah1, Nicola de'Angelis1, Pietro Riva1, Didier Mutter1,2,3, Francis Navarro4, Jacques Marescaux2,3, Patrick Pessaux1,2,3.   

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.

Entities:  

Keywords:  Robotic; cost-effective; distal pancreatectomy; laparoscopic

Year:  2018        PMID: 30498710      PMCID: PMC6230836          DOI: 10.21037/hbsn.2018.09.03

Source DB:  PubMed          Journal:  Hepatobiliary Surg Nutr        ISSN: 2304-3881            Impact factor:   7.293


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