Robotic pancreatoduodenectomy has greater postoperative complication risks than laparoscopic, especially after conversion.

• Major morbidity rates are 49% in robotic (rpd) versus 31% in laparoscopic (lpd) after conversion (p=0.021).
• Conversion required in 12% of cases, with no significant difference between robotic (12%) and laparoscopic (14%).

Surgeons should assess conversion risks when choosing robotic methods, emphasizing structured decision-making protocols and team training.

• In high-volume centers, occurrences of major morbidity and pancreatic-specific complications are notably higher in robotic cases.