Background/Objectives:Robotic surgery has emerged as a promising alternative to traditional approaches, offering enhanced precision and ergonomics. However, its application to pancreaticoduodenectomy (PD) remains controversial due to technical complexity and a steep learning curve. This study aims to evaluate the perioperative outcomes of robotic versus open PD at a single high-volume center, using inverse probability of treatment weighting (IPTW) to control for confounding variables.Methods: A retrospective, single-center analysis was conducted on patients who underwent PD between January 2020 and December 2024. Perioperative and oncological outcomes were compared using IPTW, aiming to balance potential confounding variables. The primary endpoint was 90-day postoperative mortality; secondary endpoints included operative time, estimated blood loss, major postoperative complications (Clavien-Dindo grade ≥ IIIa), and length of hospital stay.Results: Seventy-four patients were included in the intention-to-treat analysis (open:n= 31; robotic:n= 43). After IPTW adjustment, baseline characteristics were balanced across the groups. Operative time was significantly longer in the robotic group (median 540 vs. 479 min,p= 0.009). No significant differences were observed in 90-day mortality (4.9% both groups,p= 0.998), postoperative complications ≥ IIIa, or histopathological outcomes, including R0 resection and lymph node yield. Trends toward reduced estimated blood loss and shorter hospital stay in the robotic group did not reach statistical significance.Conclusions: Robotic pancreaticoduodenectomy demonstrates comparable safety and oncological efficacy to the open approach, with longer operative times but potential perioperative advantages. These findings support the continued integration of robotic techniques even in medium-volume centers with appropriate expertise.
**背景/目的：** 机器人手术作为一种有前景的替代传统手术的方式，提供了更高的精确度和更优的人体工程学。然而，由于其技术复杂性和陡峭的学习曲线，其在胰十二指肠切除术中的应用仍存在争议。本研究旨在通过使用逆概率处理加权法控制混杂变量，评估一个高手术量中心内机器人胰十二指肠切除术与开腹胰十二指肠切除术的围手术期结局。 **方法：** 对2020年1月至2024年12月期间接受胰十二指肠切除术的患者进行了一项回顾性、单中心分析。使用逆概率处理加权法比较围手术期和肿瘤学结局，旨在平衡潜在的混杂变量。主要终点是术后90天死亡率；次要终点包括手术时间、估计失血量、主要术后并发症（Clavien-Dindo分级 ≥ IIIa）以及住院时间。 **结果：** 意向性治疗分析共纳入74例患者（开腹组：n=31；机器人组：n=43）。经逆概率处理加权调整后，各组基线特征达到平衡。机器人组手术时间显著更长（中位数540分钟 vs. 479分钟，p=0.009）。在90天死亡率（两组均为4.9%，p=0.998）、≥ IIIa级术后并发症或包括R0切除和淋巴结获取数在内的组织病理学结局方面，未观察到显著差异。机器人组在减少估计失血量和缩短住院时间方面呈现趋势，但未达到统计学显著性。 **结论：** 机器人胰十二指肠切除术显示出与开腹手术相当的安全性和肿瘤学疗效，尽管手术时间更长，但具有潜在的围手术期优势。这些发现支持即使在具备适当专业能力的中等手术量中心，也应继续推广机器人技术的应用。
肿瘤(癌症)患者之家