Xie Xiaolong, Li Kewei, Xiang Bo
Department of Pediatric Surgery, West China Hospital, Sichuan University, No.37, Guoxue Alley, Chengdu, Sichuan, China.
Surg Endosc. 2025 Mar;39(3):1867-1873. doi: 10.1007/s00464-025-11561-3. Epub 2025 Jan 22.
We conducted this retrospective study to investigate the characteristics of the learning curve of total robotic jejunojejunostomy during choledochal cyst excision in pediatrics.
The study analyzed a database of medical records from the first 54 consecutive patients who underwent total robotic jejunojejunostomy during choledochal cyst excision by a single surgeon. Baseline information and postoperative outcomes were collected, and learning curves were assessed using the cumulative sum (CUSUM) method. Patients were then divided into two groups (A and B) based on the learning curve's cut-off points, and the intraoperative characteristics and postoperative outcomes were compared between the two groups.
CUSUM plots revealed that the cut-off point of the learning curve was 17 cases. The operative time of jejunojejunostomy in group A was (61.71 ± 13.47 min), which was longer than that of group B (42.43 ± 2.97 min) (p < 0.0001). No statistically significant differences were found in terms of the intraoperative bleeding, time to start diet after surgery, hospital stay, and total complications between the two groups (p > 0.05).
The learning curve for total robotic jejunojejunostomy during choledochal cyst excision in pediatrics is 17 cases, which can serve as the basis for performance guidance during future training.
我们进行了这项回顾性研究，以调查小儿胆总管囊肿切除术中全机器人空肠空肠吻合术学习曲线的特点。
该研究分析了由一名外科医生连续进行的前54例小儿胆总管囊肿切除术中全机器人空肠空肠吻合术的病历数据库。收集基线信息和术后结果，并使用累积和（CUSUM）方法评估学习曲线。然后根据学习曲线的分界点将患者分为两组（A组和B组），并比较两组的术中特征和术后结果。
CUSUM图显示学习曲线的分界点为17例。A组空肠空肠吻合术的手术时间为（61.71±13.47分钟），长于B组（42.43±2.97分钟）（p<0.0001）。两组之间在术中出血、术后开始进食时间、住院时间和总并发症方面未发现统计学上的显著差异（p>0.05）。
小儿胆总管囊肿切除术中全机器人空肠空肠吻合术的学习曲线为17例，可为未来培训中的操作指导提供依据。
