BJS open
Robotic versus open pancreatoduodenectomy in patients with obesity: propensity score-matched multicentre study
By Valle V, Marchese T, Ielpo B and 8 others.
Abstract
Background
Obesity increases morbidity after major abdominal surgery. Although the use of robotic pancreatoduodenectomy (RPD) is increasing, evidence of its outcomes in patients with obesity remains limited. This study compared perioperative outcomes of RPD versus open pancreatoduodenectomy (OPD) in patients with obesity.
Methods
This was a retrospective multicentre cohort study of patients with a body mass index (BMI) ≥ 30 kg/m2 undergoing RPD or OPD between 2012 and 2024. Propensity score matching (PSM) was used to minimize selection bias. The primary outcome was severe complications (Clavien-Dindo ≥ IIIa). Secondary outcomes included blood loss, clinically relevant postoperative pancreatic fistula (CR-POPF), clinically relevant delayed gastric emptying (CR-DGE), wound infection, length of hospital stay (LOS), 90-day mortality, and R0 resection. Factors independently associated with severe complications and CR-POPF were investigated using multivariable logistic regression. Fistula risk was classified based on the Updated Alternate Fistula Risk Score (Pancreatic Fistula Risk Score, PFRS).