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Updated: Jul 12, 2026
Robotic Central Pancreatectomy with Roux-en-Y Pancreaticojejunostomy
Published on: November 20, 2021
Comparison of robotic versus laparoscopic cyst excision and hepaticojejunostomy for choledochal cyst in children: a
Hyunhee Kwon1, Jung-Man Namgoong2, Dae Yeon Kim1
1Division of Pediatric Surgery, Asan Medical Center Children's Hospital, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Republic of Korea.
Insights
Robot-assisted surgery for pediatric choledochal cysts offers improved anastomotic quality and faster recovery compared to laparoscopic surgery. While operative time is longer, robot-assisted surgery reduces anastomotic leak rates significantly.
Area of Science:
- Pediatric Surgery
- Minimally Invasive Surgery
- Surgical Innovation
Background:
- Minimally invasive surgery (MIS) is standard for pediatric choledochal cysts (CC).
- Laparoscopic (LA) and robot-assisted (RA) approaches are utilized.
- Long-term outcomes require comparative analysis.
Purpose of the Study:
- Compare long-term outcomes of LA versus RA for pediatric CC.
- Utilize propensity score matching (PSM) to minimize bias.
- Evaluate operative time, complications, and recovery.
Main Methods:
- Retrospective review of 159 pediatric patients (June 2008-December 2020).
- Propensity score matching created 63 matched pairs (RA vs. LA).
- Comparison of operative time, complication rates, and post-operative recovery.
Main Results:
- RA group had longer operative time (359 vs. 319 min, p=0.006).
- RA group showed significantly lower anastomotic leak rates (0% vs. 7.9%, p=0.023).
- No significant differences in conversion, hospital stay, or severe complications; faster feeding initiation in RA.
Conclusions:
- Robot-assisted surgery enhances anastomosis quality and security in pediatric CC.
- Faster bowel movement recovery observed with RA.
- RA presents a valuable alternative for pediatric choledochal cyst treatment.
Background:
Minimally invasive surgery (MIS) has become a standard approach in pediatric surgery, including for the treatment of choledochal cysts (CC). This study compared the long-term outcomes of laparoscopic (LA) and robot-assisted (RA) surgeries for pediatric CC. Propensity score matching (PSM) was used to control for potential confounding variables that could influence surgical outcomes.
Methods:
A retrospective review of 159 pediatric patients who underwent MIS for CC at our tertiary referral center between June 2008 and December 2020 was conducted. PSM was used to minimize selection bias, resulting in 63 matched pairs of patients in the RA and LA groups. Key outcomes, including operative time, complication rates, and post-operative recovery, were compared between the two groups.
Results:
After PSM, the RA group had a longer mean operative time compared to the LA group (359 vs. 319 min, p = 0.006). However, the RA group had a significantly lower incidence of anastomotic leaks (0% vs. 7.9%, p = 0.023). There were no statistically significant differences between the groups in terms of conversion to open surgery, length of hospital stay, or severe complications. The RA group had a shorter time to start feeding and to achieve full feeding postoperatively.
Conclusion:
RA significantly enhances the quality of anastomosis, contributing to more secure anastomoses compared to LA, and provides the benefit of faster bowel movement recovery in pediatric choledochal cysts.
