There was little information available on the long-term oncological outcomes of patients with pancreatic ductal adenocarcinoma (PDAC) who undergo robotic pancreatectomy (RP).

Between January 2011 and December 2019, all patients who underwent RP and open pancreatectomy (OP) for resectable PDAC were included in the study. By using propensity score matching (PSM), the RP group was matched 1:1 with the OP group. Oncological results were obtained and examined.

The research had 1,606 patients in all. Following PSM, a well-balanced cohort of 335 patients from each group was chosen for further investigation. There were no significant differences in other perioperative outcomes between the RP group and the OP group, but the RP group had a shorter operative time (210 min vs. 240 min, P<0.001), lower estimated blood loss (200 ml vs. 300 ml, P=0.011), lower wound infection rates (4.5% vs. 10.1%, P=0.005), and a shorter length of postoperative hospital stay (15 days vs. 17 days, P=0.001). RFS was improved in the RP group (17 months vs. 14 months, P = 0.015), while OS was comparable between the 2 groups (31 months vs. 28 months, P=0.077). According to subgroup analysis, patients in the RP group who underwent adjuvant chemotherapy (AC) had longer median RFS (17 months vs. 14 months, P=0.024) than patients in the same patient cohort in the OP group.

For resectable PDAC, robotic pancreatectomy is risk-free and oncologically efficient. Between RP and OP, OS was equivalent, and RFS was better in the RP group, particularly for patients receiving AC.