Background/Objectives: Due to the increasing incidence of pancreatic and periampullary cancers with advancing age, coupled with the growing evidence supporting minimally invasive pancreatectomy, the demand for such procedures is rising. However, data on the feasibility of robotic pancreatectomy in octogenarian patients remain scant. This study aimed to investigate overall outcomes of robotic pancreatectomy and evaluate its safety and feasibility in octogenarian patients.Methods: A multicenter, retrospective study was conducted, including 380 patients who underwent robotic pancreatectomy at two high-volume centers in Japan from April 2020 to December 2024. Using prospectively collected data, we compared outcomes between younger patients (<80 years) and octogenarian patients (≥80 years). Multivariable logistic regression analyses were performed to assess the impact of age on postoperative outcomes.Results: Among the 380 patients, with a median age of 72 (interquartile range: 61–77) years, 213 underwent robotic pancreatoduodenectomy (RPD), and 167 underwent robotic distal pancreatectomy (RDP). Octogenarian patients were found to have more comorbidities and a higher incidence of malignant diseases. Octogenarians experienced significantly longer hospital stays post-RPD (22 [octogenarian; n = 36] vs. 14 [younger; n = 177] days,p< 0.001) and post-RDP (14 [n = 23] vs. 10.5 [n = 144] days,p= 0.02), yet their perioperative outcomes were comparable. Multivariable analyses indicated that age (≥80 years) was not a significant risk factor for major complications following robotic pancreatectomy (odds ratio, 1.33; 95% confidence interval, 0.59–2.84;p= 0.479).Conclusions: This multicenter study conducted at high-volume centers suggests that robotic pancreatectomy can be safely performed in carefully selected octogenarian patients.
背景/目的：随着胰腺及壶腹周围癌发病率随年龄增长而上升，加之微创胰腺切除术的证据日益充分，此类手术的需求不断增加。然而，关于机器人胰腺切除术在八旬患者中可行性的数据仍然匮乏。本研究旨在探讨机器人胰腺切除术的总体结果，并评估其在八旬患者中的安全性和可行性。 方法：本研究为多中心回顾性研究，纳入2020年4月至2024年12月期间在日本两家大型医疗中心接受机器人胰腺切除术的380例患者。利用前瞻性收集的数据，我们比较了年轻患者（<80岁）与八旬患者（≥80岁）的临床结局。通过多变量逻辑回归分析评估年龄对术后结果的影响。 结果：在380例中位年龄72岁（四分位距：61-77岁）的患者中，213例接受机器人胰十二指肠切除术（RPD），167例接受机器人远端胰腺切除术（RDP）。八旬患者合并症更多，恶性疾病发生率更高。八旬患者术后住院时间显著延长：RPD术后（八旬组36例）22天 vs（年轻组177例）14天（p<0.001）；RDP术后（八旬组23例）14天 vs（年轻组144例）10.5天（p=0.02），但围手术期结局相当。多变量分析显示，年龄（≥80岁）并非机器人胰腺术后主要并发症的显著危险因素（比值比1.33；95%置信区间0.59-2.84；p=0.479）。 结论：这项在大型医疗中心开展的多中心研究表明，经过严格筛选的八旬患者可以安全地接受机器人胰腺切除术。
Outcomes of Robotic Pancreatectomy in the Octogenarian: A Multicenter Retrospective Cohort Study
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