Robotic pancreatoduodenectomy (RPD) significantly lowers the risk of clinically relevant pancreatic fistula compared to open pancreatoduodenectomy (OPD).

• RPD reduced the incidence of clinically relevant pancreatic fistula by 40% (odds ratio 0.60, 95% CI 0.51-0.67).
• Over 24,000 patients were analyzed, with 5,000 undergoing RPD and 19,600 OPD.

Surgeons should consider RPD in suitable patients at high-volume centers to minimize complications.