A New Era of Bile Duct Repair: Robotic-Assisted Versus Laparoscopic Hepaticojejunostomy

Overview

Journal J Gastrointest Surg

Specialty Gastroenterology

Date 2018 Nov 8

PMID 30402722

Citations 6

Authors

Adolfo Cuendis-Velazquez

Mario Trejo-Avila

Orlando Bada-Yllan

Eduardo Cardenas-Lailson

Carlos Morales-Chavez

Luis Fernandez-Alvarez

Sujey Romero-Loera

Martin Rojano-Rodriguez

Carlos Valenzuela-Salazar

Mucio Moreno-Portillo

Affiliations

Soon will be listed here.

Abstract

Background: Despite scientific evidence of the safety, efficacy, and in some cases superiority of minimally invasive surgery in hepato-pancreato-biliary procedures, there are scarce publications about bile duct repairs. The aim of this study was to compare the outcomes of robotic-assisted surgery versus laparoscopic surgery on bile duct repair in patients with post-cholecystectomy bile duct injury.

Methods: This is a retrospective comparative study of our prospectively collected database of patients with bile duct injury who underwent robotic or laparoscopic hepaticojejunostomy.

Results: Seventy-five bile duct repairs (40 by laparoscopic and 35 by robotic-assisted surgery) were treated from 2012 to 2018. Injury types were as follows: E1 (7.5% vs. 14.3%), E2 (22.5% vs. 14.3%), E3 (40% vs. 42.9%), E4 (22.5% vs. 28.6%), and E5 (7.5% vs. 0), for laparoscopic hepaticojejunostomy (LHJ) and robotic-assisted hepaticojejunostomy (RHJ) respectively. The overall morbidity rate was similar (LHJ 27.5% vs. RHJ 22.8%, P = 0.644), during an overall median follow-up of 28 (14-50) months. In the LHJ group, the actuarial primary patency rate was 92.5% during a median follow-up of 49 (43.2-56.8) months. While in the RHJ group, the actuarial primary patency rate was 100%, during a median follow-up of 16 (12-22) months. The overall primary patency rate was 96% (LHJ 92.5% vs. RHJ 100%, log-rank P = 0.617).

Conclusion: Our results showed that the robotic approach is similar to the laparoscopic regarding safety and efficacy in attaining primary patency for bile duct repair.

Citing Articles

Emergency robotic surgery: the experience of a single center and review of the literature.

Ceccarelli G, Catena F, Avella P, Tian B, Rondelli F, Guerra G World J Emerg Surg. 2024; 19(1):28.

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Minimally invasive surgery for post cholecystectomy biliary stricture: current evidence and future perspectives.

Kalayarasan R, Sai Krishna P World J Gastrointest Surg. 2023; 15(10):2098-2107.

PMID: 37969703 PMC: 10642471. DOI: 10.4240/wjgs.v15.i10.2098.

Hepaticojejunostomy for bile duct injury: state of the art.

Marichez A, Adam J, Laurent C, Chiche L Langenbecks Arch Surg. 2023; 408(1):107.

PMID: 36843190 DOI: 10.1007/s00423-023-02818-3.

Actuarial Patency Rates of Hepatico-Jejunal Anastomosis after Repair of Bile Duct Injury at a Reference Center.

Otto W, Sierdzinski J, Smaga J, Kornasiewicz O, Dudek K, Zieniewicz K J Clin Med. 2022; 11(12).

PMID: 35743465 PMC: 9224737. DOI: 10.3390/jcm11123396.

The Role of Robotic Visceral Surgery in Patients with Adhesions: A Systematic Review and Meta-Analysis.

Milone M, Manigrasso M, Anoldo P, DAmore A, Elmore U, Giglio M J Pers Med. 2022; 12(2).

PMID: 35207795 PMC: 8878352. DOI: 10.3390/jpm12020307.

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