Robot-Assisted Choledochoduodenostomy: A Safe and Reproducible Procedure for Benign Common Bile Duct Obstruction

Abstract

Background: Choledochoduodenostomy (CD) is an option for treating choledocholithiasis and benign biliary obstruction after failure of endoscopic treatment. Nevertheless, this procedure is rarely performed using a mini-invasive approach because of its technical complexity. Robotic assistance could be a safer approach to overcome such technical issues. Methods: All consecutive patients who underwent a robot-assisted CD for benign biliary obstruction were included. Results: Between 2012 and 2016, 12 patients were operated on, 7 of whom had a body mass index over 25 (58%) and 7 were ASA class 3 (58%). The median age was 73 years (range 49-93). Median operative time was 140 min (range 105-208) and median blood loss was 90 mL (range 5-500). One patient presented with cholangitis 1 month after surgery (treated medically, Clavien-Dindo grade 2). Median length of stay was 7 days (range 3-8). None of the patients experienced severe morbidity after a median follow-up of 15 months. Conclusion: Robot-assisted CD is safe and feasible in benign biliary obstruction.

Biliary Bypass with Laparoscopic Choledochoduodenostomy

“…Robotic assisted surgery has the potential to resolve this issue. Robotic assisted choledochoduodenostomy has been described in the literature and has been shown to be safe and feasible [23,24].…”