This study shows that minimally invasive pancreatoduodenectomy (mipd) and open pancreatoduodenectomy (opd) yield similar outcomes for ampullary adenocarcinoma, regardless of subtype.

• R1 resection rates were comparable: aac-it (3.4% mipd vs. 6.9% opd) and aac-pb (9.8% mipd vs. 14.9% opd).
• Five-year overall survival rates were similar: aac-it (56.8% mipd vs. 59.5% opd) and aac-pb (52.5% mipd vs. 44.4% opd).

Surgeons can choose between mipd and opd without compromising oncological outcomes.