Robotic radical resection for hilar cholangiocarcinoma: perioperative and long-term outcomes of an initial series

Xu, Yu; Wang, Hongguang; Ji, Webin; Tang, Maosheng; Li, Hao; Leng, Jian-jun; Meng, Xuan; Dong, Jiahong

doi:10.1007/s00464-016-4925-7

Cited by 65 publications

(112 citation statements)

References 34 publications

(45 reference statements)

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“…In our study, the operative duration and blood loss volume were lower than those in previous reports . In 2012, Liu reported a series of robotic surgeries for hilar cholangiocarcinoma.…”

Section: Discussioncontrasting

confidence: 62%

Robotic radical surgery for hilar cholangiocarcinoma: A single‐centre case series

Tan

Zhang

et al. 2020

Robotics Computer Surgery

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Background Radical resection for hilar cholangiocarcinoma is considered one of the most complicated abdominal operations. We report our initial experience with robotic radical resection for hilar cholangiocarcinoma. Methods Between March 2017 and February 2019, the perioperative outcomes of 48 patients were analysed. In addition, there were two techniques for hepaticojejunostomy in the robotic approach. Comparison of the conventional and novel methods for hepaticojejunostomy was also performed to assess the efficacy of the technique. Results The operative duration and intraoperative blood loss volume was 276 minutes and 150 mL, respectively. The overall morbidity was 58.3% and the major morbidity was 10.4%. The overall mortality was 0%. No significant differences in the perioperative outcomes of hepaticojejunostomy were found between the 2 groups. Conclusion Robotic resection is a potential alternative to open surgery for appropriately selected patients with hilar cholangiocarcinoma. Further studies are required to detect the long‐term outcomes of this procedure.

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“…In our study, the operative duration and blood loss volume were lower than those in previous reports . In 2012, Liu reported a series of robotic surgeries for hilar cholangiocarcinoma.…”

Section: Discussioncontrasting

confidence: 62%

Robotic radical surgery for hilar cholangiocarcinoma: A single‐centre case series

Tan

Zhang

et al. 2020

Robotics Computer Surgery

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“…For iCCA, four comparative studies (retrospective cohort studies) and nine noncomparative studies were included for analysis . For pCCA analysis, one comparative study (retrospective cohort) and nine noncomparative studies were included . Two records had data regarding both iCCA and pCCA …”

Section: Resultsmentioning

confidence: 99%

“…During search and appraisal phase, only one comparative study was found comparing 10 cases of robotic liver resection to 32 OLR cases . Robotic liver resection had poorer results in operative time (703 ± 62 vs 475 ± 121 minutes; P < .001), morbidity (90% vs 50%; P = .031) and disease‐free survival ( P = .029) . However, there was no significant difference in estimated blood loss, major complications, postoperative mortality nor overall survival …”

Section: Resultsmentioning

confidence: 99%

“…The scarcity of comparative studies suggests that minimally invasive liver resections for pCCA are an extremely innovative procedure, and a great caution should be taken when using it, as they often require complex biliary reconstruction and portal vein resection, limiting further the wide employment of conventional laparoscopic surgery . Robotic liver resections are promising for pCCA since its instruments have greater freedom of movement in the articulating arms three‐dimensional view and a more stable retraction, enabling fine dissection and anastomosis . However, robotic procedures still demand conventional laparoscopic surgery experience and remain in development …”

Section: Discussionmentioning

confidence: 99%

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The role of minimally invasive hepatectomy for hilar and intrahepatic cholangiocarcinoma: A systematic review of the literature

Shiraiwa

Carvalho

Maeda

et al. 2020

Journal of Surgical Oncology

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Despite the fact laparoscopic liver resections (LLR) for cholangiocarcinoma is still limited, this systematic review addressed surgical and oncological outcomes of LLR to treat both perihilar cholangiocarcinoma (pCCA) and intrahepatic cholangiocarcinoma (iCCA). Five comparative and 20 noncomparative studies were found. Regarding iCCA, LLR had lower blood loss and less need for Pringle maneuver. However, open liver resections (OLR) were performed more for major hepatectomies, with better lymphadenectomy rates and higher number of harvested lymph nodes. High heterogeneity and selection bias were suggested for iCCA studies.

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“…These advantages of the robotic platform allow more precise dissection and suturing in narrow spaces which in theory would be especially useful for complex biliary surgery in the hepatic hilar region. 8,9,[26][27][28][29][30] In the present study, we report our initial experience with our first 27 consecutive RBS and our first 18 consecutive robotically constructed bilio-enteric anastomosis. 21 However, to date studies specifically reporting on RBS remain very limited worldwide.…”

Section: Introductionmentioning

confidence: 99%

Initial single institution experience with robotic biliary surgery and bilio‐enteric anastomosis in southeast Asia

Goh

Low

Teo

et al. 2019

ANZ Journal of Surgery

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Background: Presently, experience with robotic biliary surgery (RBS) is increasing worldwide although widespread adoption remains limited. In this study, we report our initial experience with RBS. Methods: Retrospective review of a single institution prospective database of 95 consecutive robotic hepatopancreatobiliary surgeries performed between 2013 and 2018. Of these, 27 patients who underwent RBS were included in this study. RBS was performed by three principal console surgeons of whom one surgeon performed 23 (85%) and supervised all cases. Additionally, to evaluate our initial outcomes with bilio-enteric anastomoses, eight consecutive pancreatoduodenectomies were included. Results: Of the 27 RBS performed, these included 10 hepaticojejunostomies with bile duct resections (including two concomitant pancreatoduodenectomies and one right hepatectomy) for choledochal cysts, bile duct strictures and biliary malignancies; five liver resections with hilar lymph node clearance for gallbladder cancer; four for Mirizzi syndrome; two cholecystectomies with cholecystoenteric fistula and two bile duct exploration after failed endoscopic treatment of choledocholithiasis. There were no open conversions, no 90-day mortality and four (14.8%) major (>Grade II) morbidities. The median postoperative stay was 6 (range 1-29) days and there was one (3.7%) 30-day readmissions. Of our first 18 robotically constructed bilio-enteric anastomoses, there was only one (5.5%) early anastomotic complication (bile leak requiring reoperation). Conclusion: Our initial experience demonstrated that RBS can be adopted safely with a low open conversion rate. Robotically constructed bilio-enteric anastomosis can be performed safely with a low anastomotic complication rate.

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Robotic radical resection for hilar cholangiocarcinoma: perioperative and long-term outcomes of an initial series

Cited by 65 publications

References 34 publications

Robotic radical surgery for hilar cholangiocarcinoma: A single‐centre case series

Robotic radical surgery for hilar cholangiocarcinoma: A single‐centre case series

The role of minimally invasive hepatectomy for hilar and intrahepatic cholangiocarcinoma: A systematic review of the literature

Initial single institution experience with robotic biliary surgery and bilio‐enteric anastomosis in southeast Asia

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