Introduction: Minimally invasive pancreatoduodenectomy is increasingly being performed globally. Technical challenges and high morbidity rates hinder the quick development of minimally invasive approaches. Methods: A single-centre retrospective analysis was conducted of all laparoscopic pancreatoduodenectomies (LPD), compared with traditional open pancreatoduodenectomies (OPD). Propensity scores were estimated based on baseline characteristics and used to create two 1:1 matched groups. Results: 67 LPDs and 105 OPDs were included for analysis. Propensity score-matching resulted in two balanced groups of both 38 cases. Principal indication were lesions in the pancreatic head (61.6%), followed by ampullary tumours (16.3%). LPD provided a significant shorter length of stay (13.5 vs. 17.0 days; p = .039) and significant longer median operative time (320.1 (±53.8) vs. 277.7 min (±63.8); p = .008). In the LPD group, the conversion rate was 22.4%. No significant difference was found between LPD and OPD in terms of median blood loss (100mL (100-300) vs. 250mL (100-600); p= .117), total complication rate (73.7% vs. 86.8%; p = .249), major complication rate (26.5% vs 10.5%: p = .137), CR-POPF rates (13.2% vs. 7.9%; p = .711), 90-day mortality rate (3.6% vs. 0%; p = .150) and R0 resection rate (85.4% vs. 85.8%), median number of lymph nodes (10.0 vs. 8.5; p = .273). Conclusion: LPD provided similar short-term and oncological outcomes, compared with the traditional open approach. Significant shorter hospital stay and longer operative times were associated with LPD. The major complication rate was non-significantly higher in LPD, without compromising overall survival.