Robot-assisted versus open surgery for adult congenital biliary dilatation: a comparative study of the short- and
Norihide Habu1, Atsushi Takahashi2, Shoichi Irie1
1Department of Hepatobiliary-Pancreatic Surgery, School of Medicine, Juntendo University, Juntendo University Hospital, 3-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
Purpose:
The clinical value of robot-assisted surgery (RAS) for adult congenital biliary dilatation (CBD), particularly regarding the long-term outcomes, remains unclear. This study compared the perioperative outcomes and late biliary complications between RAS and open surgery (OS).
Methods:
This single-center retrospective cohort study included adult patients who underwent complete excision of the extrahepatic bile duct with Roux-en-Y hepaticojejunostomy for CBD obstruction. The perioperative outcomes and late biliary complications were compared between the RAS and OS groups.
Results:
A total of 60 patients were analyzed (RAS, n = 18; OS, n = 42). The operative time was comparable between the groups (RAS: 355 min vs. OS: 334 min; P = 0.675), whereas intraoperative blood loss was lower and postoperative hospital stay was shorter in the RAS group (25 mL vs. 85 mL; P = 0.002; and 8 days vs. 18 days; P < 0.001, respectively). Major postoperative complications were comparable between the groups. During the follow-up, the incidence of late biliary complications, including anastomotic stricture and cholangitis, was similar between the RAS and OS groups. No cases of residual bile duct cancer were observed during the study period.
Conclusion:
RAS was associated with a lower blood loss and shorter postoperative hospital stay, with comparable perioperative outcomes and late biliary complications.