title: Early experience of laparoscopic and robotic hybrid pancreaticoduodenectomy.
abstract: BACKGROUND
  Laparoscopic surgery and robotic surgery have their own merits and demerits. The aim of this study was to evaluate early experiences of hybrid pancreaticoduodenectomy (PD) and to identify the learning curve of robotic surgery.
  
  
  METHODS
  Sixteen patients underwent hybrid PD from August 2015 to February 2016. The outcomes were compared with those of an open PD group by the same operator during the same period. The resection time and anastomosis time were analyzed.
  
  
  RESULTS
  Six patients in the hybrid PD group developed complications. The postoperative hospital stay in the hybrid surgery group was significantly shorter than the open PD group (10.9 ± 3.2 vs 16.9 ± 8.8 days). The total operative time of hybrid surgery was significantly longer than that of open surgery (414.7 ± 47.0 vs 266.0 ± 51.1 minutes). In hybrid surgery, the actual operation time reduced with experience, particularly anastomosis time.
  
  
  CONCLUSIONS
  Hybrid PD is feasible and safe. The learning curve of hybrid surgery, particularly robotic anastomosis, is relatively short.
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Hongbeom
authors.initials: H
authors.lastname: Kim
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jae Ri
authors.initials: JR
authors.lastname: Kim
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Youngmin
authors.initials: Y
authors.lastname: Han
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Wooil
authors.initials: W
authors.lastname: Kwon
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Sun-Whe
authors.initials: SW
authors.lastname: Kim
authors.affiliation: Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, Seoul, Republic of Korea.
authors.forename: Jin-Young
authors.initials: JY
authors.lastname: Jang
mesh_terms: D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D059032:Learning Curve; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D010190:Pancreatic Neoplasms / Q000601:surgery; D016577:Pancreaticoduodenectomy / Q000009:adverse effects / Q000379:methods*; D011183:Postoperative Complications / Q000209:etiology; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*
keywords: laparoscopy; learning curve; outcome; pancreaticoduodenectomy; robotic surgical procedure