BACKGROUND: To evaluate recent minimally invasive pancreatectomy (MIP) trends for neoplastic disease and compare perioperative outcomes. METHODS: Patients who underwent open (OS) or MIP (laparoscopic-LS or robotic-RS) pancreaticoduodenectomy (PD) or non-pancreati-coduodenectomy resections (non-PD) were identified from PINC AI Healthcare Database. Outcomes were compared using multivariable regressions. RESULTS: OS was the predominant approach for PD (87.8%)
MIP was more common in non-PD (48.5%) than PD with a substantial RS uptake (11.7%-29.9%). In PDs, outcomes were similar except OS had a longer length of stay (LOS) and lower costs. In non-PDs, MIP patients were less likely to have prolonged LOS, intensive care unit admission, and overall complications than OS. Conversion to OS was lower in the RS approach than LS in PD and non-PD. CONCLUSIONS: MIP for non-PD has become the most common operative approach with improved outcomes
MIP-PD has flat adoption and similar outcomes to OS. Robotics facilitates MIP (PD and non-PD) completion through fewer conversions to open surgery (OS).