Outcomes of Minimally Invasive vs. Open Pancreaticoduodenectomy (Whipple Procedure)

Pancreaticoduodenectomy, commonly known as the Whipple procedure, remains the cornerstone surgical treatment for malignancy and benign periampullary and pancreatic head lesions. Over the past two decades, the advent of minimally invasive surgery techniques, including laparoscopic and robot-assisted approaches, has transformed the landscape of pancreatic surgery. Despite significant improvements in perioperative care and surgical instrumentation, the adoption of minimally invasive pancreaticoduodenectomy (MIPD) has been cautious because of its complexity, steep learning curve, and oncological adequacy concerns. This study aimed to provide a comprehensive comparative analysis between MIPD and open pancreaticoduodenectomy, focusing on perioperative outcomes, complication profiles, oncological clearance, hospital stay duration, cost-effectiveness, and long-term survival. Data from recent randomised controlled trials and multicentre studies were analysed to provide an evidence-based perspective on the benefits and limitations of each approach. Emerging trends, including enhanced recovery after surgery protocols and hybrid techniques, have also been discussed. These findings suggest that while MIPD offers reduced blood loss, shorter hospital stays, and faster recovery, its technical demands and marginally longer operative times necessitate careful patient selection and high-volume centre expertise. No significant compromise in the oncological outcomes was observed. As surgical robotics evolves and experience grows, MIPD may emerge as the preferred modality in selected patient populations.