Related Experiment Video
Updated: May 20, 2026
07:36
Laparoscopic Common Bile Duct Exploration in Patients with a Previous History of Biliary Tract Surgery
Published on: February 10, 2023
Robot-assisted common bile duct exploration as an option for complex choledocholithiasis
Nawar A Alkhamesi1, Ward T Davies, R Fiona Pinto
1Canadian Surgical Technologies & Advance Robotics, University Hospital, London Health Science Centre, London, ON, Canada. n.alkhamesi@imperial.ac.uk
Surgical Endoscopy
|July 10, 2012
Summary
Robot-assisted common bile duct exploration (CBDE) shows promise for patients with difficult gallstones when endoscopic retrograde cholangiopancreatography (ERCP) fails. Careful patient selection may improve outcomes in this challenging surgical scenario.
Area of Science:
- Minimally Invasive Surgery
- Gastroenterology
- Surgical Technology
Background:
- Choledocholithiasis (bile duct stones) often requires intervention when endoscopic retrograde cholangiopancreatography (ERCP) fails.
- Robot-assisted common bile duct exploration (CBDE) is an emerging technique for managing complex cases.
- Comparing robotic CBDE with traditional open surgery provides insights into efficacy and safety.
Purpose of the Study:
- To evaluate the initial experience with robot-assisted CBDE for choledocholithiasis resistant to endoscopic therapy.
- To compare the outcomes of robot-assisted CBDE with open CBDE in a matched cohort.
Main Methods:
- A retrospective analysis of 55 CBDE procedures performed between 2005 and 2010.
- 19 robot-assisted cases and 18 open surgery cases were analyzed on an intent-to-treat basis.
- Exclusion criteria included emergency cases and non-stone related explorations.
Main Results:
- Robot-assisted CBDE had a longer mean operating time (220 min) than open surgery (169 min) (P=0.01).
- Robot-assisted CBDE resulted in a shorter median hospital stay (4 days vs. 11 days) (P=0.02).
- Conversion to open surgery occurred in 21% of robotic cases; complication rates and T-tube usage were similar between groups.
Conclusions:
- Robot-assisted CBDE presents potential benefits for managing choledocholithiasis refractory to ERCP.
- Optimizing patient selection is crucial for maximizing the success of robot-assisted CBDE.
