This study shows that using a stapler for pancreatic transection in robot-assisted pancreaticoduodenectomy reduces clinically relevant postoperative pancreatic fistulas.

• The stapler method group had a cr-popf incidence of 13.1% compared to 31.5% in the conventional group (p=0.014).
• Body mass index is a risk factor for cr-popf (OR 1.34), while the stapler method reduced risk (OR 0.31).

Surgeons should consider the stapler method to improve postoperative outcomes without increasing complication rates.

• Postoperative amylase levels were higher with the stapler method, but acute pancreatitis rates were similar (1.6% vs. 1.4%).