Robotic Versus Laparoscopic Pancreaticoduodenectomy: A Review of Contemporary Evidence on Surgical Outcomes and Learning Curve.

INTRODUCTION

Robotic pancreaticoduodenectomy (RPD) offers technical advantages over laparoscopic pancreaticoduodenectomy (LPD), including improved dexterity, visualisation, and ergonomics. However, its clinical superiority remains uncertain.

METHODS

A structured narrative review supported by a systematic PubMed/MEDLINE search of literature published between 2016 and 2025 was performed. Comparative studies evaluating RPD and LPD were included, comprising six meta-analyses and six cohort studies.

RESULTS

RPD and LPD demonstrated comparable mortality, major complications, postoperative pancreatic fistula, delayed gastric emptying, and oncologic outcomes. RPD consistently showed lower conversion rates and reduced blood loss, transfusion requirements, and hospital stay. Operative time and postoperative morbidity showed heterogeneous findings. Outcomes were strongly influenced by learning curve completion and institutional volume.

CONCLUSIONS

RPD provides selective technical and perioperative advantages, particularly in experienced high-volume centres. However, definitive clinical superiority over LPD remains unproven, and current conclusions remain limited by observational evidence, study overlap, and heterogeneity in learning curve stage and operative technique.