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Updated: Jun 7, 2025
Robot-Assisted Radical Antegrade Modular Pancreatosplenectomy Including Resection and Reconstruction of the Spleno-Mesenteric Junction
Published on: January 3, 2020
Evolution from laparoscopic to robotic radical resection for gallbladder cancer: a propensity score-matched
Changwei Dou1, Mu He1,2, Qingqing Wu1,2
1General Surgery, Cancer Center, Department of Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, 158 Shangtang Road, Hangzhou, 310014, Zhejiang, China.
Robotic radical resection (RRR) for gallbladder cancer (GBC) offers comparable outcomes to laparoscopic radical resection (LRR), with reduced intraoperative bleeding and increased lymph node yield. Both methods demonstrate similar survival rates and complication profiles.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Gallbladder cancer (GBC) treatment is increasingly utilizing robotic and laparoscopic approaches.
- These minimally invasive techniques are reported to offer advantages over traditional open surgery.
Purpose of the Study:
- To compare perioperative outcomes and long-term survival between robotic radical resection (RRR) and laparoscopic radical resection (LRR) for GBC.
- To identify risk factors for postoperative complications and overall survival in GBC patients undergoing radical resection.
Main Methods:
- A retrospective study included 109 GBC patients undergoing radical resection.
- Propensity score matching (1:1) was used to compare RRR (21 patients) and LRR (88 patients) groups.
- Logistic regression analysis identified risk factors for overall survival (OS) and Clavien-Dindo (C-D) Grades III-IV complications.
Main Results:
- After propensity score matching, RRR showed significantly less intraoperative bleeding and higher lymph node yield compared to LRR.
- Perioperative outcomes, including operation length, postoperative complications (C-D Grades III-IV), hospital stay, and 30/90-day mortality, were comparable between RRR and LRR.
- Overall survival rates at 1, 2, and 3 years were similar between the groups (P=0.593).
- Preoperative total bilirubin (TB) ≥ 72 µmol/L and biliary reconstruction were independent risk factors for severe complications; T3 stage was a risk factor for OS.
Conclusions:
- Robotic radical resection (RRR) for gallbladder cancer (GBC) is a safe and feasible option.
- RRR demonstrates potential advantages over laparoscopic radical resection (LRR) by reducing intraoperative bleeding and increasing lymph node retrieval.
- Both RRR and LRR offer comparable perioperative outcomes, postoperative recovery, and overall survival for GBC patients.
