BACKGROUND Although robotic surgery is popular around the world, its safety and efficacy over classical open surgery is still controversial. The purpose of this article is to compare the safety and efficacy of robotic pancreaticoduodenectomy (RPD) and open pancreaticoduodenectomy (OPD). METHODS A literature search of PubMed, Web of Science, and the Cochrane Library database up to July 29, 2018 was performed and the meta-analysis was performed using RevMan 5.2 software with Fixed and random effects models applied. The IRB approval and written consent were not needed for this paper. RESULTS Twelve non-randomized retrospective studies and 1 non-randomized prospective study consisting of 2403 patients were included in this meta-analysis. There were 788 (33%) patients in the RPD group and 1615 (67%) patients in the OPD group. Although RPD was associated with a longer operative time (weighted mean difference [WMD]: 71.74 min; 95% CI 23.37-120.12; p = 0.004), patient might benefit from less blood loss (WMD: - 374.03 ml; 95% CI - 506.84 to - 241.21; p < 0.00001), shorter length of stay (WMD: - 5.19 day; 95% CI - 8.42 to - 1.97; p = 0.002), and lower wound infection rate (odds ratio: 0.17; 95% CI 0.04-0.80; p = 0.02). No statistically significant difference was observed in positive margin rate, lymph nodes harvested, postoperative complications, reoperation or readmission rate, and mortality rate. CONCLUSIONS Robotic pancreaticoduodenectomy is a safe and feasible alternative to open pancreaticoduodenectomy with regard to short-term outcomes. Further studies on the long-term outcomes of these surgical techniques are needed.

中文翻译：

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机器人与开放式十二指肠切除术：短期结果的荟萃分析。

背景技术尽管机器人手术在世界范围内很流行，但是其相对于传统开放手术的安全性和有效性仍存在争议。本文的目的是比较机器人胰十二指肠切除术（RPD）和开放式胰十二指肠切除术（OPD）的安全性和有效性。方法截至2018年7月29日，对PubMed，Web of Science和Cochrane图书馆数据库进行文献检索，并使用RevMan 5.2软件应用固定效应和随机效应模型进行荟萃分析。本文不需要IRB的批准和书面同意。结果这项荟萃分析包括12项非随机回顾性研究和1项由2403例患者组成的非随机前瞻性研究。RPD组有788名患者（33％），OPD组有1615名患者（67％）。尽管RPD与手术时间更长有关（加权平均差异[WMD]：71.74分钟； 95％CI 23.37-120.12； p = 0.004），但患者可能会从失血量减少中受益（WMD：-374.03 ml； 95％CI- 506.84至-241.21; p <0.00001），住院时间较短（WMD：-5.19天; 95％CI-8.42至-1.97; p = 0.002），伤口感染率较低（比值：0.17; 95％CI 0.04） -0.80； p = 0.02）。在阳性切缘率，收获的淋巴结，术后并发症，再手术或再入院率和死亡率上均未观察到统计学上的显着差异。结论就短期结局而言，机器人胰十二指肠切除术是一种安全可行的替代胰十二指肠切除术的替代方案。需要对这些手术技术的长期结果进行进一步研究。