Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
J Laparoendosc Adv Surg Tech A. 2024 Jan;34(1):55-60. doi: 10.1089/lap.2023.0376. Epub 2023 Dec 21.
Minimally invasive surgery (MIS) for cyst excision and Roux-en-Y hepaticojejunostomy (HJ) is widely performed for adult choledochal cysts. Few articles compared the robotic and laparoscopic approaches for choledochal cysts. Between 2014 and 2022, 157 patients who underwent MIS for choledochal cysts were retrospectively analyzed. Perioperative outcomes of patients who underwent totally robotic surgery, robot-assisted surgery, and laparoscopic surgery were compared, respectively. Also, postoperative outcomes of patients with robotic reconstruction and laparoscopic reconstruction during HJ were compared. Perioperative outcomes were comparable between robotic and laparoscopic groups. The suturing technique for the anterior and posterior walls of the HJ differed significantly between the robotic and laparoscopic reconstruction groups ( = .001). However, there were no significant differences in postoperative outcomes, including total complications ( = .304), major complications ( = .411), and postoperative interventions ( = .411), between the two groups. The robotic and laparoscopic approaches for adult choledochal cysts have comparable surgical outcomes. In the MIS era, robotic surgery could be an alternative surgical option for adult choledochal cysts.
微创胆囊切除术 (MIS) 和 Roux-en-Y 肝肠吻合术 (HJ) 广泛用于成人胆总管囊肿。很少有文章比较机器人和腹腔镜方法治疗胆总管囊肿。回顾性分析了 2014 年至 2022 年间 157 例行 MIS 治疗胆总管囊肿的患者。比较了完全机器人手术、机器人辅助手术和腹腔镜手术患者的围手术期结果，并比较了 HJ 中机器人重建和腹腔镜重建患者的术后结果。机器人组和腹腔镜组的围手术期结果相当。机器人和腹腔镜重建组 HJ 的前壁和后壁缝合技术有显著差异（ = .001）。然而，两组患者的总并发症（ = .304）、主要并发症（ = .411）和术后干预（ = .411）等术后结果均无显著差异。成人胆总管囊肿的机器人和腹腔镜方法具有相当的手术结果。在 MIS 时代，机器人手术可能成为成人胆总管囊肿的另一种手术选择。
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