Robotic-Assisted vs. Open Lateral Pancreaticojejunostomy for Chronic Pancreatitis: Perioperative Outcomes and...

Objectives Chronic pancreatitis (CP) is characterized by debilitating pain, for which lateral pancreaticojejunostomy (LPJ) is an established decompressive procedure in patients with a dilated main pancreatic duct (MPD). This study compared perioperative outcomes and short-term pain-related recovery between robotic-assisted and open LPJ. Methods This retrospective analysis of a prospectively maintained database included consecutive adults with CP who underwent LPJ at a tertiary care center in India. Baseline demographic and clinical data were collected preoperatively. Perioperative outcomes were monitored during the index admission and for 30 days following surgery, whereas pain and functional recovery were evaluated preoperatively, at discharge, and three months after the procedure. Results The study cohort comprised 23 patients, including 11 who underwent robotic surgery and 12 who underwent the open procedure. Baseline demographic and clinical characteristics were similar between the two groups. All robotic procedures were completed without conversion. The robotic approach was associated with a significantly longer operative duration than the open procedure (332.7 ± 43.4 vs. 166.8 ± 33.1 minutes; p < 0.001). Despite this difference, intraoperative safety and short-term postoperative outcomes were comparable, with neither group experiencing major complications, readmissions, or mortality. Time to oral intake and ICU stay were comparable between groups; however, hospital stay was significantly shorter following robotic LPJ (p < 0.001). While preoperative pain measures were similar, robotic LPJ was associated with significantly lower postoperative pain intensity (30.91 ± 9.44 vs. 54.17 ± 14.43; p < 0.001), reduced work disability (31.82 ± 11.68 vs. 45.83 ± 17.94; p = 0.039), and lower Izbicki pain scores (19.43 ± 4.05 vs. 28.75 ± 6.19; p < 0.001). At three-month follow-up, pain and functional outcomes were low and comparable between groups. Conclusions Robotic-assisted LPJ is safe and feasible, with comparable perioperative outcomes and improved early postoperative pain outcomes compared with open surgery.