Robotic pancreatoduodenectomy in patients 80 and older shows significant benefits over open surgery.

• Operative time was longer for robotic (441 min) vs. open (375 min), but with less blood loss (266 ml vs. 565 ml).
• Postoperative complications were lower with robotic surgery (52.2% vs. 70.6% for open, p = .013) as well as rates of pancreatic fistula (9.3% vs. 29.4%, p < .001).

Robotic surgery may be a safer option for surgical candidates in this age group when performed in experienced centers.

• Average hospital stay was shorter after robotic surgery (13 days vs. 21 days, p = .002).