Robotic surgery of gallbladder cancer

Abstract

Aim: The aim of this study was to describe our technique for the surgical treatment of clinically suspected or incidentally diagnosed gallbladder cancer (GBC) and to report the outcomes of our experience.

Methods: This is a retrospective observational study including consecutive patients operated by a robotic approach for the surgical treatment of clinically suspected or incidentally diagnosed GBC (with the intent of radical re-resection after index cholecystectomy) performed between January 2017 and December 2019. Clinical outcomes and technical details related to the robotic approach were analyzed.

Results: During the study period, 8 patients underwent robotic radical cholecystectomy with lymphadenectomy and atypical resection of segments IVb-V. No conversion or major complications occurred intraoperatively. All patients underwent a radical resection. There were one Clavien-Dindo grade II and one grade IIIb complication. Median hospital stay was 6 days (range 5-11). At a median follow-up of 17.5 months (range 29.3-7.3), all patients are alive and free from disease except one who had peritoneal recurrence and underwent chemotherapy. No trocar site recurrence was observed.

Conclusion: The present study describes a standardized step-by-step robotic technique for the surgical treatment of GBC and demonstrates the feasibility and safety of the robotic approach. More data and multicentre series are needed to confirm our results and to assess the oncologic outcomes of the robotic approach.

Keywords

Gallbladder cancer / robotic surgery / radical cholecystectomy / incidental gallbladder cancer / lymphadenectomy / minimally invasive surgery

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