Robotic pancreaticojejunostomy linked to shorter hospital stay in Dutch cohort

A nationwide retrospective cohort study compared robotic and open lateral pancreaticojejunostomy in 133 adults with symptomatic wide-duct chronic pancreatitis. Robotic surgery was associated with a shorter median hospital stay, but postoperative pancreatic fistula was more frequent; the authors call for randomized trials.

Robotic surgery was associated with a two-day shorter median stay.
Major complication rates did not differ significantly.
Grade B/C pancreatic fistula was more frequent after robotic surgery.
The retrospective findings need confirmation in randomized trials.

Lateral pancreaticojejunostomy is used to treat symptomatic wide-duct chronic pancreatitis in patients with a normal-size pancreatic head. This nationwide, multicenter retrospective cohort included 133 adults who underwent the operation in the Netherlands between 2010 and 2025: 36 had robotic surgery and 97 had open surgery. The primary outcomes were hospital stay and major complications, defined as Clavien–Dindo grade III or higher.

Median hospital stay was 5 days after robotic surgery and 7 days after open surgery (P<0.001). Major complication rates were not significantly different (36.1% vs 26.8%; P=0.405), and operative times were comparable. Robotic surgery was associated with lower median blood loss (100 vs 300 mL; P<0.001), but grade B/C postoperative pancreatic fistula was more frequent (22.2% vs 7.2%; P=0.034). There were no conversions among the 36 robotic cases and no 90-day deaths in the overall cohort. Findings remained broadly consistent after propensity-score matching.

The observational comparison reflects early nationwide experience and cannot establish that the surgical approach caused the differences. The higher fistula rate and potential learning-curve effects warrant further evaluation. The authors recommend randomized trials in experienced centers before the potential benefits of robotic surgery are considered established.

In practice

For adults with symptomatic wide-duct chronic pancreatitis undergoing lateral pancreaticojejunostomy, this retrospective Dutch cohort found a shorter median stay with the robotic approach, but also a higher rate of grade B/C postoperative pancreatic fistula. Major complications and operative time did not differ significantly. These early, nonrandomized results do not establish that robotic surgery is preferable or support changing practice; patient selection, center experience, and possible learning-curve effects require further assessment, including in randomized trials.

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Source

Surgical Endoscopy: Early nationwide experience with robotic versus open lateral pancreaticojejunostomy for symptomatic wide-duct chronic pancreatitis ↗

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