Related Experiment Video
Updated: Feb 24, 2026
Robotic-assisted Lateral Pancreaticojejunostomy for Chronic Pancreatitis
Published on: September 5, 2025
Robotic Versus Laparoscopic Pancreaticoduodenectomy: a NSQIP Analysis
Ibrahim Nassour1, Sam C Wang1,2, Matthew R Porembka1,2
1Division of Surgical Oncology, Department of Surgery, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
Background:
An increasing body of literature is supporting the safety of minimally invasive pancreaticoduodenectomy compared to open pancreaticoduodenectomy, but there are limited comparative studies between laparoscopic and robotic pancreaticoduodenectomy. The aim of this study was to compare the rate of postoperative 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy.
Methods:
Patients who underwent laparoscopic and robotic pancreaticoduodenectomy were abstracted from the 2014-2015 pancreas-targeted American College of Surgeons National Surgical Quality Improvement Program. A multivariable logistic regression model was developed to determine if the type of minimally invasive approach was associated with 30-day overall complications.
Results:
We identified 428 minimally invasive pancreaticoduodenectomy cases, of which 235 (55%) were performed laparoscopically and 193 (45%) robotically. Patients who underwent the robotic approach were more likely to be white compared to those who underwent the laparoscopic approach and were less likely to have pulmonary disease, undergo preoperative radiotherapy, and have vascular and multivisceral resection. On multivariable analysis, we found that the type of minimally invasive approach, whether laparoscopic or robotic, was not associated with overall complications. The predictors of 30-day overall complications were higher body mass index (odds ratio [OR], 1.05; 95% confidence interval [CI], 1.02-1.09), vascular resection (OR, 2.10; 95% CI, 1.23-3.58), and longer operative time (OR, 1.002; 95% CI, 1.001-1.004).
Conclusions:
Robotic pancreaticoduodenectomy was associated with a similar 30-day overall complication rate to laparoscopic pancreaticoduodenectomy. Further studies are needed to corroborate these findings and to establish the best approach to perform this complex operation.
Insights
Laparoscopic and robotic pancreaticoduodenectomy show similar 30-day complication rates. Further research is needed to determine the optimal approach for this complex surgery, considering factors like BMI and operative time.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Minimally invasive pancreaticoduodenectomy is increasingly recognized for its safety.
- Limited comparative data exists between laparoscopic and robotic approaches for this procedure.
Purpose of the Study:
- To compare the 30-day overall complication rates between laparoscopic and robotic pancreaticoduodenectomy.
- To identify factors influencing complications in minimally invasive pancreaticoduodenectomy.
Main Methods:
- Analysis of 428 cases from the 2014-2015 American College of Surgeons National Surgical Quality Improvement Program.
- Multivariable logistic regression to assess the association between surgical approach and complications.
Main Results:
- No significant difference in 30-day overall complications between laparoscopic and robotic pancreaticoduodenectomy.
- Predictors of complications included higher BMI, vascular resection, and longer operative time.
Conclusions:
- Robotic pancreaticoduodenectomy demonstrates comparable safety to laparoscopic pancreaticoduodenectomy regarding 30-day complications.
- Additional studies are required to establish the optimal surgical technique.
