Systematic review and meta-analysis of prospective trials of robotic versus open pancreatoduodenectomy

A systematic review and meta-analysis of prospective non-randomized and randomized trials analyzed the short-term outcomes of robotic partial pancreatoduodenectomy (RPD) compared with open partial pancreaticoduodenectomy (OPD). The analysis included 7 studies (3 randomized controlled trials and 4 comparative cohort trials) published before 27^th November 2025. In total, 1440 patients were allocated to RPD (n=718) or OPD (n=722). The main outcome was 90-day mortality. For this outcome, no significant difference was observed between RPD and OPD (OR 1.07; 95% CI 0.04-29.40). There were also no significant differences for the outcomes clinically relevant complications, reoperation rates, lymph node yield, RO resection rate, operative time, and length of hospital stay. Readmission rates favored OPD (OR 1.22; 95% CI 1.15-1.28), while there was a lower amount of intraoperative blood loss in RPD (SMD -0.98; 95% CI -1.65 to -0.32). The authors conclude that mortality following RPD was comparable to mortality following OPD.