title: Systematic review and meta-analysis of robotic versus laparoscopic distal pancreatectomy for benign and malignant pancreatic lesions.
abstract: The number of published series on minimally invasive distal pancreatectomy has significantly increased. Robotic systems can overcome some limitations of laparoscopy. This study aimed to compare two techniques in distal pancreatectomy.
  
  
  
  Multiple electronic databases were systematically searched to identify studies (up to July 2015) that compared perioperative outcomes between robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP). Relative risks with 95 % confidence intervals (CIs) were estimated.
  
  
  
  Nine studies were enrolled in this review. Four studies reported on operative time, indicating no difference between the RDP and LDP groups (WMD = 21.55, 95 % CI -65.28-108.37, P = 0.63). No significant difference between the two groups was indicated with respect to the number of patients who converted to open (OR 0.35, 95 % CI 0.11-1.13, P = 0.08), spleen preservation rate (OR 2.37, 95 % CI 0.50-11.30, P = 0.28), and transfusion rate (OR 1.30, 95 % CI 0.54-3.13, P = 0.56). In addition, no difference was indicated in the incidence of pancreatic fistulas (OR 1.05, 95 % CI 0.67-1.65, P = 0.83) and length of hospital stay between the two groups (WMD = -0.61, 95 % CI -1.40-0.19, P = 0.13).
  
  
  
  RDP seems to be a safe and effective alternative to LDP. Large randomized controlled trials are needed to verify the results of this meta-analysis.
authors.affiliation: Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China.
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.affiliation: Department of Emergency Surgery, Sichuan Academy of Medical Sciences and Sichuan Provincial People's Hospital, Chengdu, 610072, Sichuan Province, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Feng
authors.affiliation: Department of Vascular Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan Province, China. zjcwch@163.com.
authors.forename: Jichun
authors.initials: J
authors.lastname: Zhao
mesh_terms: D001803:Blood Transfusion / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay; D061646:Operative Time; D059351:Organ Sparing Treatments / Q000706:statistics & numerical data; D010180:Pancreatectomy / Q000379:methods*; D010182:Pancreatic Diseases / Q000601:surgery; D010185:Pancreatic Fistula / Q000453:epidemiology*; D010190:Pancreatic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology*; D065287:Robotic Surgical Procedures / Q000379:methods*; D013154:Spleen; D016896:Treatment Outcome
keywords: Complications; Distal pancreatectomy; Laparoscopy; Robotic surgery