title: A comparison between robotic-assisted laparoscopic distal pancreatectomy versus laparoscopic distal pancreatectomy.
abstract: BACKGROUND
  This study aims to compare the early perioperative outcomes of robotic-assisted laparoscopic distal pancreatectomy (RDP) versus laparoscopic distal pancreatectomy (LDP).
  
  
  METHODS
  The clinicopathologic features of 45 consecutive patients who underwent minimally-invasive distal pancreatectomy from 2006 to 2015 were retrospectively reviewed.
  
  
  RESULTS
  Thirty-nine patients who met our study criteria were included. Eight patients underwent RDP and 31 had LDP. There were 10 (25.6%) open conversions. Six (15.4%) patients had major (> grade 2) morbidities and there was no in-hospital mortality. There were 14 (35.9%) grade A and 9 (23.1%) grade B pancreatic fistulas. Comparison between RDP and LDP demonstrated no significant difference between the patients' baseline characteristics except there was increased frequency of spleen-preserving pancreatectomies (3 (37.5%) vs 25 (80.6%), P=0.016) and splenic-vessel preservation (5 (62.5%) vs 4 (12.9%), P=0.003) in RDP. Comparison between outcomes demonstrated that RDP was associated with a longer median operation time (452.5 (range, 300-685) vs 245 min (range, 85-430), P=0.001) and increased frequency of the procedure completed purely laparoscopically (8 (100%) vs 18 (58.1%), P=0.025).
  
  
  CONCLUSIONS
  RDP can be safely adopted and is equivalent to LDP in most perioperative outcomes. It is also associated with a decreased frequency of the need for hand-assistance laparoscopic surgery or open conversion but needed a longer operation time. Copyright © 2016 John Wiley & Sons, Ltd.
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Brian K P
authors.initials: BK
authors.lastname: Goh
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors.forename: Chung Yip
authors.initials: CY
authors.lastname: Chan
authors.affiliation: Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
authors.forename: Hui-Ling
authors.initials: HL
authors.lastname: Soh
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors.forename: Ser Yee
authors.initials: SY
authors.lastname: Lee
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors.forename: Peng-Chung
authors.initials: PC
authors.lastname: Cheow
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Pierce K H
authors.initials: PK
authors.lastname: Chow
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: London L P J
authors.initials: LL
authors.lastname: Ooi
authors.affiliation: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, National University of Singapore, Singapore.
authors.forename: Alexander Y F
authors.initials: AY
authors.lastname: Chung
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010180:Pancreatectomy / Q000379:methods*; D010185:Pancreatic Fistula; D010190:Pancreatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D065287:Robotic Surgical Procedures / Q000379:methods*; D013154:Spleen / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: MIS; comparison; laparoscopic distal pancreatectomy; laparoscopy; minimally invasive surgery; outcome; pancreatectomy; robotic