title: A meta-analysis of robotic-assisted pancreatectomy versus laparoscopic and open pancreatectomy.
abstract: OBJECTIVE
  To perform a meta-analysis of eligible studies from multiple medical centers to assess the safety, feasibility, and efficacy of robotic-assisted pancreatectomy (RP).
  
  
  METHODS
  We searched the electronic databases PubMed and EMBASE for studies comparing RP with laparoscopic pancreatectomy (LP) and open pancreatectomy (OP) for patients with pancreatic disease from June 2009 to June 2012. Continuous variables were pooled using the standardized mean difference (SMD) and odds ratio (OR), and dichotomous variables were pooled using the risk difference (RD) method. For all analyses, the 95% confidence interval (CI) was calculated. Three studies comparing RP and LP, and 4 studies comparing RP and OP were suitable for meta-analysis.
  
  
  RESULTS
  Six published studies met the inclusion criteria. Our results showed that RP can reduce estimated blood loss and duration of hospitalization more than OP. For pancreatic fistula, there were no statistical differences between RP, OP, and LP, and no significant differences in intraoperative conversion rates between RP and LP. Robotic-assisted pancreatectomy may be able to increase microscopic negative margins of resection (R0) and spleen preserving rates.
  
  
  CONCLUSIONS
  Robotic-assisted pancreatectomy was associated with increased R0 resection rates and spleen preserving rates than LP and OP. Moreover, RP can reduce estimated blood loss and duration of hospitalization more than OP. A robotic approach to pancreatectomy may be suited to patients with pancreatic disease.
authors.affiliation: Department of General Surgery, Sixth People`s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People`s Republic of China.
authors.forename: Yigang
authors.initials: Y
authors.lastname: Chen
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.forename: Ziming
authors.initials: Z
authors.lastname: Yuan
authors.forename: Song
authors.initials: S
authors.lastname: Yu
authors.forename: Zhigang
authors.initials: Z
authors.lastname: Wang
authors.forename: Qi
authors.initials: Q
authors.lastname: Zheng
mesh_terms: D006801:Humans; D010535:Laparoscopy; D010180:Pancreatectomy / Q000379:methods*; D065287:Robotic Surgical Procedures