Robotic longitudinal pancreaticojejunostomy for chronic pancreatitis: Comparison of clinical outcomes and cost to the open approach

Int J Med Robot. 2017 Sep;13(3). doi: 10.1002/rcs.1832. Epub 2017 May 26.

Abstract

Background: This study compares clinical and cost outcomes of robot-assisted laparoscopic (RAL) and open longitudinal pancreaticojejunostomy (LPJ) for chronic pancreatitis.

Methods: Clinical and cost data were retrospectively compared between open and RAL LPJ performed at a single center from 2008-2015.

Results: Twenty-six patients underwent LPJ: 19 open and 7 RAL. Two robot-assisted cases converted to open were included in the open group for analysis. Patients undergoing RAL LPJ had less intraoperative blood loss, a shorter surgical length of stay, and lower medication costs. Operation supply cost was higher in the RAL group. No difference in hospitalization cost was found.

Conclusions: Versus the open approach, RAL LPJ performed for chronic pancreatitis shortens hospitalization and reduces medication costs; hospitalization costs are equivalent. A higher operative cost for RAL LPJ is mitigated by a shorter hospitalization. Decreased morbidity and healthcare resource economy support use of the robotic approach for LPJ when appropriate.

Keywords: Puestow procedure; cost analysis, outcomes assessment; longitudinal pancreaticojejunostomy; robotic surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Costs and Cost Analysis
  • Female
  • Health Care Costs
  • Humans
  • Laparoscopy / economics
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures / economics
  • Minimally Invasive Surgical Procedures / methods
  • Pancreaticojejunostomy / economics
  • Pancreaticojejunostomy / methods*
  • Pancreatitis, Chronic / economics
  • Pancreatitis, Chronic / surgery*
  • Retrospective Studies
  • Robotic Surgical Procedures / economics
  • Robotic Surgical Procedures / methods*
  • Treatment Outcome