52 Comparative Efficacy and Safety of Laparoscopic vs. Robotic Pancreatic Necrosectomy: A Systematic Review and Meta-Analysis Free

Pancreatic necrosectomy is a critical intervention in severe acute pancreatitis, with minimally invasive techniques like laparoscopy and robotics becoming increasingly prevalent. This systematic review and meta-analysis compare the efficacy, safety, and outcomes of laparoscopic versus robotic pancreatic necrosectomy.

A comprehensive search was conducted across PubMed, Embase, and Cochrane Library databases for studies comparing laparoscopic and robotic pancreatic necrosectomy. Eligible studies were assessed for methodological quality, and data were extracted for meta-analysis.

Twelve studies involving 897 patients (laparoscopic: n = 486; robotic: n = 411) were included. The meta-analysis showed similar efficacy between the two approaches in terms of necrosectomy completion rate (OR 0.78; 95% CI 0.52–1.16), operative time (MD -4.12; 95% CI -13.64–5.41), and postoperative hospital stay (MD -0.26; 95% CI -1.29–0.76). However, robotic necrosectomy was associated with significantly lower conversion rates to open surgery (OR 0.45; 95% CI 0.28–0.72) and reduced intraoperative blood loss (MD -82.14; 95% CI -122.55–-41.72). Safety outcomes, including postoperative complications and mortality rates, were comparable between the techniques.

Both laparoscopic and robotic pancreatic necrosectomy are effective and safe approaches for managing severe acute pancreatitis. Robotic surgery offers advantages in terms of lower conversion rates and reduced intraoperative blood loss. However, further high-quality studies are necessary to validate these findings and assess long-term outcomes.