A comparison of laparoscopic and robotic distal pancreatectomy with spleen and Splenic vessels preservation: an intention-based evaluation in a single-center retrospective study.

PURPOSE: To compare the short-term outcomes of robotic distal pancreatectomy (RDP) and laparoscopic distal pancreatectomy (LDP), with a particular focus on the actual completion rates of spleen and splenic vessels preservation preoperatively.

METHODS

Fifty-two RDP and 87 LDP procedures performed between 2014 and 2024 were retrospectively analyzed.

RESULTS

The operative time was significantly longer for RDP than for LDP (median 407 min vs. 320 min, p < 0.0001), whereas the intraoperative blood loss was significantly lower (median 70 mL vs. 100 mL, p = 0.011). The rate of conversion to open surgery was also lower for RDP (2% vs. 10%, p = 0.042). The spleen preservation rate, defined as the proportion of cases in which spleen preservation was achieved preoperatively, was 100% (12/12) and 92% (23/25) in the RDP and LDP groups, respectively (p = 0.203). The splenic vessels preservation rate was significantly higher with RDP (100% [10/10]) than with LDP (67% [16/24]; p = 0.011). Postoperative complication rates did not differ significantly between the two groups.

CONCLUSIONS

Compared with LDP, RDP was associated with significantly reduced intraoperative blood loss, a lower conversion rate to open surgery, and a higher success rate in splenic vessels preservation, suggesting the technical advantages of RDP.