与腹腔镜远端胰腺切除术（LDP）相比，机器人远端胰腺切除术（RDP）的转化率较低，失血量也较少。 LDP 与 PDAC 开放手术具有相似的肿瘤学结果。本研究的目的是比较 RDP 与 LDP 治疗 PDAC 的肥胖患者的围手术期和肿瘤学结果。回顾性地，纳入了 2012 年至 2022 年间在 12 个国际专家中心接受 RDP 或 LDP 治疗 PDAC 的所有肥胖患者。共 372 名患者，共纳入 81 名患者。两组之间的所有基线特征均具有可比性。 RDP 与失血量减少（495mlLDP 对比 188mlRDP；p = 0.003）、较低的转化率（13.5%RDP 对比 36.4%LDP；p = 0.019）以及 Clavien-Dindo ≥ 3 种并发症发生率较低（13.5%RDP 对比.36.4%LDP；p = 0.019）。总体生存率和无病生存率具有可比性。在患有左侧 PDAC 的肥胖患者中，机器人方法与改善术中结果和减少严重并发症有关。© 2023 John Wiley

Robotic distal pancreatectomy (RDP) is associated with a lower conversion rate and less blood loss than laparoscopic distal pancreatectomy (LDP). LDP has similar oncological outcomes as open surgery in PDAC. The aim of this study was to compare perioperative and oncological outcomes in obese patients with RDP versus LDP for PDAC.Retrospectively, all obese patients who underwent RDP or LDP for PDAC between 2012 and 2022 at 12 international expert centres were included.out of 372, 81 patients were included. All baseline features were comparable between the two groups. RDP was associated with decreased blood loss (495mlLDP vs. 188mlRDP; p = 0.003), lower conversion rate (13.5%RDP vs. 36.4%LDP; p = 0.019) and lower rate of Clavien-Dindo ≥3 complications (13.5%RDP vs. 36.4%LDP; p = 0.019). Overall and disease-free survival were comparable.In obese patients with left-sided PDAC, the robotic approach was associated with improved intraoperative outcomes and fewer severe complications.© 2023 John Wiley & Sons Ltd.