Evaluating the value of robotic versus open pancreaticoduodenectomy: improved clinical outcomes without compromising hospital revenue per admission
- 1Hepato-Biliary-Pancreatic Surgery Division and Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113- 0033 Japan
Abstract
Purpose: Robotic pancreaticoduodenectomy has been increasingly adopted; however, its economic feasibility under the Japanese national health insurance system remains unclear. This study aimed to evaluate the clinical and economic outcomes of robotic pancreaticoduodenectomy (RPD) compared with open pancreaticoduodenectomy (OPD).
Methods: Patients who underwent pancreaticoduodenectomy between January 2020 and December 2024 at The University of Tokyo were identified from an institutional database. Patients with pancreatic ductal adenocarcinoma were excluded because portal vein resection and reconstruction performed on a robotic platform were not covered by the Japanese National Health Insurance System during the study period. The clinical outcomes and economic indicators, including hospital revenue, costs, and profit, were assessed under the Japanese lump-sum payment system.
Results: Eighty-three patients were included in the study (41 in the robotic group and 42 in the open group). The rate of clinically relevant pancreatic fistula was significantly lower (2.4% vs. 45.2%, P < 0.001), and the median hospital stay was significantly shorter (7.0 vs. 22.5 days, P < 0.001) in the robotic group. The mean hospital revenue per admission (22,007 vs. 19,701 USD, P = 0.015) and profit per day (2,552 vs. 793 USD, P < 0.001) were significantly higher in the robotic group.
Conclusions: Robotic pancreaticoduodenectomy yielded superior perioperative outcomes and shorter hospitalization than open pancreaticoduodenectomy in selected patients without compromising hospital revenue per admission.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03451-5.
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BibTeX
@article{seki2026evaluating,
title = {{Evaluating the value of robotic versus open pancreaticoduodenectomy: improved clinical outcomes without compromising hospital revenue per admission}},
author = {Yusuke Seki and Yoshikuni Kawaguchi and Takeshi Kano and Kyoji Ito and Satoru Abe and Yujiro Nishioka and Akihiko Ichida and Takeshi Takamoto and Nobuhisa Akamatsu and Kiyoshi Hasegawa},
journal = {Surgery Today},
year = {2026},
month = aug,
doi = {10.1007/s00595-026-03451-5},
url = {https://doi.org/10.1007/s00595-026-03451-5},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Evaluating the value of robotic versus open pancreaticoduodenectomy: improved clinical outcomes without compromising hospital revenue per admission
AU - Yusuke Seki
AU - Yoshikuni Kawaguchi
AU - Takeshi Kano
AU - Kyoji Ito
AU - Satoru Abe
AU - Yujiro Nishioka
AU - Akihiko Ichida
AU - Takeshi Takamoto
AU - Nobuhisa Akamatsu
AU - Kiyoshi Hasegawa
PY - 2026
DA - 2026/08/06
JO - Surgery Today
DO - 10.1007/s00595-026-03451-5
UR - https://doi.org/10.1007/s00595-026-03451-5
AB - Purpose: Robotic pancreaticoduodenectomy has been increasingly adopted; however, its economic feasibility under the Japanese national health insurance system remains unclear. This study aimed to evaluate the clinical and economic outcomes of robotic pancreaticoduodenectomy (RPD) compared with open pancreaticoduodenectomy (OPD). Methods: Patients who underwent pancreaticoduodenectomy between January 2020 and December 2024 at The University of Tokyo were identified from an institutional database. Patients with pancreatic ductal adenocarcinoma were excluded because portal vein resection and reconstruction performed on a robotic platform were not covered by the Japanese National Health Insurance System during the study period. The clinical outcomes and economic indicators, including hospital revenue, costs, and profit, were assessed under the Japanese lump-sum payment system. Results: Eighty-three patients were included in the study (41 in the robotic group and 42 in the open group). The rate of clinically relevant pancreatic fistula was significantly lower (2.4% vs. 45.2%, P < 0.001), and the median hospital stay was significantly shorter (7.0 vs. 22.5 days, P < 0.001) in the robotic group. The mean hospital revenue per admission (22,007 vs. 19,701 USD, P = 0.015) and profit per day (2,552 vs. 793 USD, P < 0.001) were significantly higher in the robotic group. Conclusions: Robotic pancreaticoduodenectomy yielded superior perioperative outcomes and shorter hospitalization than open pancreaticoduodenectomy in selected patients without compromising hospital revenue per admission. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s00595-026-03451-5.
SN - 0941-1291
SN - 1436-2813
ER -