Failure to rescue after pancreatoduodenectomy and the advent of robotic surgery: outcomes across 20 years practice.

Among 572 open and 140 robotic PDs, median age was 68 years and 50.1% were female.

Major complications occurred in 28%.

Compared with open pancreatoduodenectomy, robotic procedures showed fewer major complications (21% vs 30%, p = 0.042) and shorter median hospital stay (7 vs 9 days, p < 0.001).

FTR was not influenced by surgical approach, but was associated with higher comorbidity, organ failure and lack of timely intensive care unit escalation.