An Operative Time Threshold for Safety in Robotic Pancreaticoduodenectomy

Robotic pancreaticoduodenectomy (RPD) is a safe and effective procedure, although it often takes longer than open pancreaticoduodenectomy (OPD). A study analyzed elective, low-risk RPD and OPD cases to determine the operative time threshold (OTT) for safety in RPD patients. The OTT was identified as 7.7 hours, and patients whose RPD exceeded this threshold had higher rates of major morbidity and 30-day mortality compared to the OPD cohort. Risk factors for prolonged RPD included preoperative obstructive jaundice and a pancreatic duct size of less than 3mm or 3-6mm. The study suggests using the OTT to improve patient selection for RPD and as a competency-based quality benchmark.