Robotic Versus Open Distal Pancreatectomy: A Propensity Score Matching Analysis

Background: Minimally invasive distal pancreatectomy offers recognised benefits over open surgery. Robotic surgery, with its shorter learning curve and technical advancements, presents a promising alternative to laparoscopy in managing pancreatic diseases. Methods: This study enrolled consecutive patients undergoing distal pancreatectomy between January 2013 and May 2022. After propensity score matching, perioperative and medium-term outcomes were compared between robotic and open procedures. Results: Among 79 patients analysed, 50 were eligible after matching. Both groups showed similar demographics, with 11% experiencing grade III-IV complications, and one patient died within 90 days after surgery. Robotic surgery exhibited longer operating times but allowed for earlier refeeding, drain removal, canalisation, and shorter hospital stays compared with open surgery. Spleen preservation rates, postoperative pancreatic fistula occurrences and survival were comparable between the groups. Conclusions: Overall, robotic and open distal pancreatectomy demonstrated similar outcomes, with robotic surgery offering advantages in certain postoperative parameters despite longer operation times. © 2024 John Wiley & Sons Ltd.