Robotic pancreaticoduodenectomy in the young

Pancreaticoduodenectomy is rarely performed in young patients, and the impact of age on surgical and survival outcomes after robotic pancreaticoduodenectomy has not been extensively studied. This study aimed to evaluate the surgical and survival outcomes of patients aged < 50 years who underwent robotic pancreaticoduodenectomy. A comparative study was conducted on patients who underwent robotic pancreaticoduodenectomy divided into two groups: young (age, < 50 years) and old (age, ≥ 50 years). A total of 555 patients were included in this study, with 53 (9.5%) in the young group and 502 (90.5%) in the old group. Periampullary adenocarcinomas were less common in the young group (32.1% vs. 76.5%), whereas solid and pseudopapillary tumors (9.4% vs. 1.0%) and neuroendocrine tumors (15.1% vs. 3.6%) were more common. Soft pancreatic parenchyma (77.4% vs. 62.5%) and non-dilated (≤ 3 mm) pancreatic ducts (77.4% vs. 46.3%) were more prevalent in the young group. The young group had a shorter length of stay (median, 16 vs. 20 days). There were no significant differences in the other surgical outcomes and risks. Survival outcomes for overall periampullary adenocarcinoma favored the young group, with a 5-year survival rate of 76.4% vs. 46.7% in the old group. Robotic pancreaticoduodenectomy in the young patients (< 50 years) is associated with comparable surgical outcomes and favorable survival outcomes for periampullary adenocarcinoma compared with the older patients (≥ 50 years). These findings highlight the feasibility and safety of robotic pancreaticoduodenectomy in the young population.