Comparison of perioperative outcomes between robotic and laparoscopic pancreaticoduodenectomy: a single-center propensity score matching analysis

Minimally invasive pancreaticoduodenectomy (MIPD), including laparoscopic PD (LPD) and robotic-assisted PD (RPD), has gradually become prevalent. Comparisons between LPD and RPD remain relatively limited, and conclusions are still controversial. This study aimed to compare the perioperative outcomes between LPD and RPD. This was a retrospective study. We reviewed the records of patients who underwent LPD or RPD from January 2019 to December 2024. Perioperative outcomes were compared before and after propensity score matching (PSM). A total of 375 patients were included in this study, with 180 patients undergoing LPD and 195 undergoing RPD. After PSM, 139 patients were included in each group, and baseline characteristics were well balanced. Compared to the LPD group, the RPD group had a shorter operation time (median 290.00 vs. 355.00 min, P < 0.001), less blood loss (median 100.00 vs. 300.00 mL, P < 0.001), a lower rate of intraoperative red blood cell (RBC) transfusion (21.58% vs. 39.57%, P = 0.001), a lower rate of conversion to open surgery (2.16% vs. 7.91%, P = 0.028), and a shorter postoperative hospital stay (median 13.00 vs. 17.00 days, P = 0.003). There were no significant differences between the two groups in terms of postoperative complications or short-term oncological outcomes. RPD offered several advantages over LPD, including shorter operation time, less blood loss, lower rate of conversion, lower rate of intraoperative RBC transfusion, and shorter postoperative hospital stay. For patients with malignant tumors, both LPD and RPD demonstrated similar short-term oncological outcomes.