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Related Experiment Video

Updated: May 3, 2026

Robotic Left Hepatectomy using Indocyanine Green Fluorescence Imaging for an Intrahepatic Complex Biliary Cyst
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Consensus Statements on Minimally Invasive Surgery for Congenital Biliary Dilatation.

So Nakamura1,2, Takahisa Tainaka3, Yoshitaka Kiya4

  • 1Department of Surgery and Oncology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.

Asian Journal of Endoscopic Surgery
|December 15, 2025
PubMed
Summary

Minimally invasive surgery for congenital biliary dilatation (MICBD) is supported by expert consensus for Todani types I and IV-A. Experienced surgical teams should perform these procedures, though more evidence is needed.

Keywords:
congenital biliary dilatationlaparoscopic surgeryminimally invasive surgeryrobot‐assisted surgery

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Area of Science:

  • Surgical Innovation
  • Hepatobiliary Surgery
  • Pediatric Surgery

Background:

  • Minimally invasive surgery for congenital biliary dilatation (MICBD) is increasingly adopted.
  • Evidence for MICBD, particularly in adult and pediatric populations, is limited.

Purpose of the Study:

  • To establish expert consensus on the use of MICBD for congenital biliary dilatation.
  • To address clinical questions regarding MICBD in Todani classification types I and IV-A.

Main Methods:

  • Multidisciplinary consensus meeting.
  • Comprehensive literature review and expert survey.
  • Delphi voting process for consensus statements (≥75% agreement).

Main Results:

  • MICBD showed reduced blood loss and shorter hospital stays, with comparable complication rates to open surgery.
  • Expert survey: 81% supported MICBD for type I, 64% for type IV-A.
  • Consensus statement: MICBD for types I and IV-A is considered, preferably by experienced teams; achieved unanimous agreement.

Conclusions:

  • Formal recommendations for MICBD are premature due to limited high-level evidence.
  • Expert consensus supports MICBD for Todani types I and IV-A by experienced teams.
  • Further high-quality studies are essential to confirm safety and efficacy.