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QoL was evaluated using the EORTC QLQ-C30 and EQ-5D questionnaires, self-reported by patients. After a propensity score matching, which included BMI, gender, operation time, multiorgan and vascular resections, splenic preservation, and pancreatic stump management, the mean differential cost and Quality-Adjusted Life Years (QALY) were calculated and plotted on a cost-utility plane.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The study population consisted of 564 patients. Among these, 271 (49%) patients were submitted to LDP, while 293 (51%) patients to RDP. After propensity score matching, the study population was composed of 159 patients in each group, with a median follow-up of 59\u00a0months. As regards the QoL analysis, global health and emotional functioning domains showed better results in the RDP group (<jats:italic>p<\/jats:italic>\u2009=\u20090.037 and <jats:italic>p<\/jats:italic>\u2009=\u20090.026, respectively), whereas the other did not differ. As expected, the median crude costs analysis confirmed that RDP was more expensive than LDP (16,041 Euros vs. 10,335 Euros, <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). However, the robotic approach had a higher probability of being more cost-effective than the laparoscopic procedure when a willingness to pay more than 5697 Euros\/QALY was accepted.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>RDP was associated with better QoL as explored by specific domains. Crude costs were higher for RDP, and the cost-effectiveness threshold was set at 5697 euros\/QALY.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00464-024-10849-0","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T07:32:48Z","timestamp":1724311968000},"page":"5881-5890","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Nationwide cost-effectiveness and quality of life analysis of minimally invasive distal pancreatectomy"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5244-4357","authenticated-orcid":false,"given":"Matteo","family":"De Pastena","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Esposito","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"Paiella","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Greta","family":"Montagnini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina C.","family":"Zingaretti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Ramera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danila","family":"Azzolina","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dario","family":"Gregori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele F.","family":"Kauffmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Giardino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luca","family":"Moraldi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Butturini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ugo","family":"Boggi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Salvia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"10849_CR1","doi-asserted-by":"publisher","first-page":"283","DOI":"10.1016\/j.yasu.2009.02.013","volume":"43","author":"NB Merchant","year":"2009","unstructured":"Merchant NB, Parikh AA, Kooby DA (2009) Should all distal pancreatectomies be performed laparoscopically? 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Zingaretti, Marco Ramera, Danila Azzolina, Dario Gregori, Emanuele F. Kauffmann, Alessandro Giardino, Luca Moraldi, Giovanni Butturini, Ugo Boggi, Roberto Salvia have no conflicts of interest or financial ties to disclose. Salvatore Paiella received consultancy honoraria from AlphaTau.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Disclosure"}}]}}