Robotic vs open Puestow procedure for chronic pancreatitis: an updated 15-year experience

Introduction Pain from chronic pancreatitis (CP) impairs quality of life and demands continuous treatment, whether pharmacological, endoscopic or surgical. Surgical treatment for CP can include solely decompression, resection, or a combination of both. The modified Puestow [1] procedure is an established indication for patients with a dilated pancreatic duct and without the need for parenchyma resection. Methods We report a series of 48 patients who have undergone a Puestow procedure from January 2009 to July 2025 (28 open and 21 robotic). Results This is a retrospective review of a prospectively maintained database. Comparison between groups reveals a shorter overall hospital length of stay and zero readmissions among the robotic group (respectively p = 0.036 and 0.029), as well as no difference in morbidity or operative time when compared to open cases. Conclusion At our high-volume HPB center, robotic Puestow procedures are safe and feasible, with similar complication rates and earlier discharge.