{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T11:02:56Z","timestamp":1789470176423,"version":"build-2803163510"},"reference-count":35,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Minimally invasive approaches to pancreatoduodenectomy (PD) are increasingly being adopted worldwide. However, direct comparisons between laparoscopic PD (LPD) and robot-assisted PD (RPD) remain limited and inconclusive. This study aimed to compare perioperative outcomes between LPD and RPD within a national multicentre cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective multicentre study included patients who underwent LPD or RPD at participating Italian centres within the Italian Group of Minimally Invasive Pancreas Surgery registry between October 2019 and December 2024. Propensity score matching was performed in a 1 : 1 ratio based on age, body mass index, American Society of Anaesthesiologists score, tumour type (pancreatic ductal adenocarcinoma versus other histologies), receipt of neoadjuvant chemotherapy, and requirement for vascular and\/or organ resection. Primary outcomes were estimated blood loss and operative time. Secondary outcomes included conversion rate, postoperative morbidity, pancreas-related complications, reoperation, length of hospital stay, histopathological features, and deaths.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 774 minimally invasive PDs, 163 (21.1%) were LPD and 611 (78.9%) were RPD. After propensity score matching , 161 LPDs were compared with 161 RPDs. RPD was associated with a longer operative time (median 506 (interquartile range (i.q.r.) 427.5\u2013600) versus 500 (411.5\u2013551) minutes; P = 0.030) but lower estimated blood loss (median 200 (i.q.r. 100\u2013337.5)\u2005ml versus 250 (150\u2013500)\u2005ml; P &amp;lt; 0.001). On multivariable analysis, surgical approach was not an independent predictor of operative time, whereas RPD was independently associated with lower estimated blood loss (\u03b2 \u22120.372, 95% confidence interval \u22120.641 to \u22120.102; P = 0.007). Conversion to open surgery was significantly more frequent after LPD (24 of 161; 14.9%) than RPD (11 of 161; 6.8%) (P = 0.023). Postoperative outcomes\u2014including major morbidity, pancreas-specific complications, reoperation, length of hospital stay, and in-hospital or 90-day deaths\u2014were comparable between groups. Histopathological findings were also similar.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>RPD was associated with lower estimated blood loss and a reduced conversion rate compared with LPD. However, these differences were modest in absolute terms and did not translate into clinically meaningful differences in postoperative outcomes, which remained comparable between the two approaches.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag152","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:49:27Z","timestamp":1786535367000},"source":"Crossref","is-referenced-by-count":0,"title":["Surgical outcomes after robot-assisted\n                    <i>versus<\/i>\n                    laparoscopic pancreatoduodenectomy: multicentre propensity-matched comparison from the Italian Group of Minimally Invasive Pancreatic Surgery"],"prefix":"10.1093","volume":"10","author":[{"given":"Giuseppe","family":"Quero","sequence":"first","affiliation":[{"name":"Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS di Roma , Rome ,","place":["Italy"]},{"name":"Dipartimento di Medicina e Chiurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore di Roma , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta","family":"Menghi","sequence":"additional","affiliation":[{"name":"Digestive Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS di Roma , Rome ,","place":["Italy"]},{"name":"Dipartimento di Medicina e Chiurgia Traslazionale, Universit\u00e0 Cattolica del Sacro Cuore di Roma , Rome ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niccol\u00f2","family":"Napoli","sequence":"additional","affiliation":[{"name":"Division of General and Transplant Surgery, University of Pisa , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allegra","family":"Ripolli","sequence":"additional","affiliation":[{"name":"Division of General and Transplant Surgery, University of Pisa , Pisa ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Oncologic Surgery, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Mazzola","sequence":"additional","affiliation":[{"name":"Department of Minimally Invasive and Oncologic Surgery, ASST Grande Ospedale Metropolitano Niguarda , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5393-6783","authenticated-orcid":false,"given":"Elisa","family":"Bannone","sequence":"additional","affiliation":[{"name":"Unit of HPB Surgery, Pederzoli Hospital , Peschiera del Garda ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Butturini","sequence":"additional","affiliation":[{"name":"Unit of HPB Surgery, Pederzoli Hospital , Peschiera del Garda ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo Giuseppe","family":"Viola","sequence":"additional","affiliation":[{"name":"General Surgery Department, G. 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