To compare perioperative safety and efficacy of robot-assisted spleen-preserving distal pancreatectomy (RSPDP) and laparoscopic spleen-preserving distal pancreatectomy (LSPDP) for benign or low-grade malignant lesions of pancreatic body and tail, and to evaluate clinical benefits of RSPDP patients.

Clinical data of 35 patients with benign or low-grade malignant lesions of pancreatic body and tail undergoing spleen-preserving distal splenectomy in the Affiliated Hospital of Guizhou Medical University from January 2019 to December 2024 were analyzed retrospectively. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 12 patients were male and 23 female, aged (51±19) years on average. According to different surgical methods, all patients were divided into the RSPDP group (n=14) and LSPDP group (n=21). According to specific conditions during the surgery, spleen-preserving distal pancreatectomy was performed using Kimura or Warshaw technique. Perioperative indexes between two groups were compared by rank-sum test, and the incidence of complications was compared by Fisher's exact test.

All patients in two groups successfully completed the surgery, and no perioperative death occurred. In the RSPDP group, Kimura technique was adopted in 9 cases, and 14 cases in the LSPDP group. The splenic vessel-preserving rates in two groups were 64%(9/14) and 67%(14/21), with no statistical significance (P>0.999). The median intraoperative blood loss in the RSPDP group was 40(20,63) ml, significantly less than 100(50,300) ml in the LSPDP group (Z=-2.638, P=0.007). No significant difference was observed in operation time and blood transfusion amount between two groups (all P>0.05). No significant difference was found in the amount of amylase in drainage fluid, extubation time and the incidence of splenic infarction, pancreatic fistula and abdominal infection rate between two groups (all P>0.05).

Both RSPDP and LSPDP are safe for patients with benign or low-grade malignant lesions of pancreatic body and tail. No significant difference is observed in operation time and postoperative recovery between two groups. Compared with LSPDP, RSPDP leads to a lower amount of intraoperative bleeding.