TPW 7.12 An Early Clinical Outcome Study Comparing Surgical Modalities in Abandoned Major Pancreatic Surgery at a Tertiary Centre
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ID: 323992
2026
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Abstract
Abstract There is a 5-10% chance pancreatic ductal adenocarcinoma (PDAC) resections are abandoned intra-operatively due to undetected local invasion or metastasis. Robotic surgery is associated with reduced length of stay (LOS) compared to open resection, but it is unclear if this applies to abandoned procedures. This study compares LOS and time to palliative chemotherapy initiation after an abandoned resection between open and robotic cases at a tertiary hepatopancreatobiliary centre. Patients with PDAC undergoing surgical resection between April 2023 and November 2025 were retrospectively identified (n=329). Patients were stratified by procedure into pancreaticoduodenectomy (Whipple's) or distal pancreatectomy with splenectomy (DPS), and subsequently by surgical approach. Data was collected from electronic health records and regional HPB CNS teams. Twenty-seven patients (mean age 71; 70% male) underwent abandoned resections; 25 were intended Whipple’s. Both intended DPS procedures were robotic, as were two intended Whipple’s. Median LOS was 4 days for open procedures and 1.5 days for robotic procedures. No complications in the robotic group. Mann–Whitney U analysis demonstrated significantly shorter LOS following abandoned robotic procedures compared with open surgery (p=0.0047, 1% significance level). Median time to chemotherapy initiation was 57 days (IQR 25–65) for robotic procedures and 44 days (IQR 34–74) for open procedures. This study highlights early differences between surgical modalities on clinical outcomes. Findings suggest abandoned robotic pancreatic surgery may reduce LOS compared to open cases. Time to chemotherapy was comparable. The small retrospective cohort and few robotic cases limit interpretation. Further data is required for longer-term outcome assessment.
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openalex_W7172491569
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| Authors | Esther Sleigh, Declan McDonnell, Zaed Hamady, Ali Arshad |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag087.381
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| URL | |
| Keywords | Keywords not found |
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