Journal Article

DKFZ-2026-01145

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png Robotic Pancreatoduodenectomy Carries Greater Risk of Morbidity after Conversion than Laparoscopy: A Propensity Score-Matched Analysis in the E-MIPS Registry.

Bertrand, T. ; Baggerman van Houweninge, C. E. ; Bjornsson, B. ; Piardi, T. ; Keck, T. ; van den Boezem, P. ; Burgdorf, S. ; Ausania, F. ; Bratlie, S. O. ; Petric, M. ; Ruess, D. A.DKFZ* ; Roeyen, G. ; D'Hondt, M. ; Molenaar, I. Q. ; Jorba, R. ; van Santvoort, H. ; Pando, E. ; Aussilhou, B. (Contributor) ; Pencavel, T. ; Sparrelid, E. ; Besselink, M. G. ; Dokmak, S. ; Hilal, M. A. ; Surgery, E. c. o. M. I. P. (Collaboration Author) ; Andreou, A. (Contributor) ; Bekheit, M. (Contributor) ; Bozkurt, E. (Contributor) ; Fristrup, C. W. (Contributor) ; Busch, O. (Contributor) ; Can, M. F. (Contributor) ; Caputo, D. (Contributor) ; Cecka, F. (Contributor) ; Coratti, A. (Contributor) ; van Dam, R. (Contributor) ; Delis, S. (Contributor) ; Di Martino, M. (Contributor) ; Del Pozo, C. D. (Contributor) ; Ferrari, G. (Contributor) ; Festen, S. (Contributor) ; Fara, R. (Contributor) ; Oberparleiter, S. (Contributor) ; Gaujoux, S. (Contributor) ; Koerkamp, B. G. (Contributor) ; Gryspeerdt, F. (Contributor) ; Ielpo, B. (Contributor) ; Jarosciakova, S. (Contributor) ; Kaldarov, A. R. (Contributor) ; Khatkov, I. (Contributor) ; Kleive, D. (Contributor) ; Lingohr, P. (Contributor) ; Linnemann, J. (Contributor) ; Lips, D. (Contributor) ; Lopez-Ben, S. (Contributor) ; Lovecek, M. (Contributor) ; Luyer, M. (Contributor) ; Bio (Contributor) ; Navez, J. (Contributor) ; Pauletti, B. (Contributor) ; Pessaux, P. (Contributor) ; Ramia, J. M. (Contributor) ; Rosso, E. (Contributor) ; Saint-Marc, O. (Contributor) ; Sánchez-Cabús, S. (Contributor) ; van der Schelling, G. (Contributor) ; Sergeant, G. (Contributor) ; Seppänen, H. (Contributor) ; Serrablo, A. (Contributor) ; Soonawalla, Z. (Contributor) ; Souche, R. (Contributor) ; Sousa, F. (Contributor) ; Silva, D. S. (Contributor) ; Suarez-Munoz, M. A. (Contributor) ; Sutcliffe, R. P. (Contributor) ; Tingstedt, B. (Contributor) ; Toso, C. (Contributor) ; Wellner, U. F. (Contributor)

2026
Lippincott Williams & Wilkins [Erscheinungsort nicht ermittelbar]

Abstract: To compare postoperative outcome following conversion in robotic (RPD) versus laparoscopic (LPD) pancreatoduodenectomy.Minimally invasive pancreatoduodenectomy (MIPD) is increasingly performed using RPD or LPD. Conversion to open surgery is a risk factor for postoperative morbidity, and its impact may vary by surgical approach.Retrospective, propensity-score matched multicenter cohort from the E-MIPS registry across 75 European centers (January 2019-2024). Patients undergoing conversion during RPD or LPD were matched 1:1. Outcomes were also analyzed by conversion type (pre-emptive vs urgent). Primary outcome was 30-day major morbidity (Clavien-Dindo ≥3). Secondary outcomes included pancreas-specific complications, length of stay, and Ideal Outcome (no mortality, major morbidity, POPF B/C, reoperation, prolonged stay, or readmission). Centers were stratified as low- (<20 MIPD/year) or high-volume (≥20/year).Of 2201 MIPD patients, 269 (12%) required conversion, with no difference between RPD (181/1568, 12%) and LPD (88/633, 14%; P=0.13). After matching (88 RPD vs. 88 LPD), RPD conversion was associated with higher major morbidity (49% vs. 31%; P=0.021), especially in pre-emptive conversion (47% vs. 30%; P=0.043). In high-volume centers, major morbidity (48.4% vs 29.4%) and POPF grade B/C was more frequent in RPD than LPD (24% vs. 8%; P=0.019). Blood loss was greater in RPD overall and in both pre-emptive and urgent conversions (all P < 0.01).Despite comparable conversion rates, RPD conversion was associated with higher morbidity. Structured decision-making protocols and robotic team training regarding conversion are warranted.

Keyword(s): Conversion ; Laparoscopic Pancreatoduodenectomy ; Robotic Pancreatoduodenectomy

Note: #DKTKZFB9# / epub

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Contributing Institute(s):

1. DKTK Koordinierungsstelle Freiburg (FR01)

Research Program(s):

1. 899 - ohne Topic (POF4-899) (POF4-899)

Appears in the scientific report 2026

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Database coverage:
; Allianz-Lizenz ; Clarivate Analytics Master Journal List ; Current Contents - Clinical Medicine ; Current Contents - Life Sciences ; Essential Science Indicators ; IF >= 5 ; JCR ; PubMed Central ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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